HomeMy WebLinkAboutHomestead_Shoultz (11)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R6/4-03)
Prescribed by tiro Department of Loral Government Finance
INSTRUCTIONS: See reverse side fln!ling ins»ucb'orxs.
W YEAR
Clorl
FJL
'ID[
�t-�1'
I (We) T certify th to are rlsstfday of March, 20
1 (We) occupied as our principal place of residence the following described r property for which a Home fad Property ax Credit is hereby claimed:
-- , �%L r AUDITOR
(We) owned ❑ 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.
-1�t`WY ,`��^�:.. "50 =-, ki r r, 5•. .,a :._;7r.?_
.. <'�.. �- r„ - CONTRACT +RECORDED_z -,,;
If buying on contract, Fee Simple owners name
Recorders office where centract is recorded Recerd number Page
iPROPERTY.. DESCRIPT10Nss_. =mss-• rti €"�a e...`.t•- - .c " g_ ' , -:.
County
Tamship
Tadng dist net (cjty, toywt, town hip)
Parcel number p ^�
Legal description
Is the property in qua n_
1 / /
❑ Real property ❑ Mobile Homo (1.C. 6- 1.1 -7)
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.
yp�p� o?(o -oa -�� ioo- 9o0.23a -o��
:y;. s."- :r;,l� r. ���i, �"` �„- � „sz.��4l��oE'PROP.ERTYOWNEDIBY CLAIMANT,IN'OTNER "CO'UNTIESy`k �.�'" y, ��' 13 „`'K•u;:'f�,.r��,r;ti"'``�',,�{7 �'1�,?�t`'
County Tavnship
County Township
I hereby certify the above statements are We, correct and complete.
Sign
ure of claimant
Addfoss (Timber strty 51ZP code) lb V
-�
ASSESSOR USE ONLY' -rte' -'
,r.ydy'.ryVALUE'-AT.
°�.
c TRUE TAX a
ASSESSED VALUE
700 %O V•il
v.F -....F �,
HOMESTEADttNOIJREStDENT1AL
xc`.'II�iVALUEr�
,- r
5
-.. �i1..'.k- .VALUE,.3:?
Land not exceeding 1 (one) acre immediately
9qy e Vii
r N
surmundin residential improvements.
Other land
2
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Motile / Manufactured Home
Garage
(5)'
-
Other improvements
(6)
r�•-5” ”` "
Total improvements (line 4 through line 6)
(T)
Total value (line 3 plus line 7)
(S)
1 hereby certify the above is We, coned, and
Signature of Assessor
Data signed
complete.
verifying action - Signature of Auditor
Date signed
W,0rjv —AWX-�! ,4—V - && STAN DAR 6. DEDUCTION BALL'OWANCE*
®
20 Pay 20_ _ -
Lesser of 112 Homestead
valuation or 535.000
S
Signature ofAuditor Date signed