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HomeMy WebLinkAboutHomestead_Richardson (2)Y CLAIM FOR HOMESTEAD PROPERTY TAX i CREDIT /STANDARD DEDUCTION State Farm 5473 (R215 -92) i INSTRUCTIONS: See reverse side for filing instructions. . = -^' CERTIFICATI FORM YEAR HC10 i STATEMENT'.. 1W, - ." •. I (We) _ - _ _ certify that on the 1st day of March, 19 IWWe) occupied as our principal place of residen a the followi escribed al property for which a Homestead Property Tax Credit is hereby claimed: I (We) owned [D Are buying under contract Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract. _ - CONTRACT RECORDED.. it buying on contract, Fee Simple owner's name Recorder's office where contract is recorded Record number Page PROPERTY DESCRIPTION - ` . - " " " _ . •. County Township Taxing district ( ,town, township) Parcel number Legal description NC� q•� a If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income. PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES - County Township County Township hereby certify the above statements are true, correct and complete. Signatur o aimant ' Address number and street, ary state ZIP code) #tI] y� tD�lo ASSESSOR USE ONLY ._ TRUETAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENT1ALti VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements. 5 Valuation or $2,000 - Other land (2) ' Total land (line 1 plus line 2) (3) Residential improvements Dwelling (4) 1� Garage (5) - Other improvements (6) Total improvements (line 4 through line 6) (7) Total value (line 3 plus line 7) (6) 1 hereby Certify the above is true, correct, and complete. Signature of Assessor Date signed tying action - Signature of Auditor Date signed STANDARD DEDUCTION ALLOWANCE 19_Payl9_ Lesser of 1/2 Homestead 5 Valuation or $2,000 Signature of Auditor 1 / Date signed '