HomeMy WebLinkAboutHomestead_TurnerCLAIM-FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 IRS 14-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
FORM YEAR
HC10
FILET)
I (We) kLopw o P x/ e. —certify that on the 1st day of March. 20_
I (We) occupied as our principal place Uesid4(ce, the following described real property for which a Homestead P = Tax is hereby claimed:
❑❑ Are buying under contract
I (We) owned � el�
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns qpKyl,�O
oyp
sjY AUDITOR
uymg under a contract.
f ACONTRACT,RECORDEDI:`:% • 7.
If buying on contract, Fee Simple owner's name,
Recorders office where contract Is recorded Record number Page
PROPERTYDESICRIP.TION'l-
County
T-ms"', p
Taxing district (city to!�to�s
1
Par6eInumW
nship
Is the property'
,_
I Kilealproperry,
)R q untion:
❑ Mobile Home I.C. 51.1-7)
If any portion of the residential structure or the land not exceeding we (1) am that immediately surrounds that 90ructure is used to produce Income, describe the use and portion
of the property utilized to produce Income.
N
'A"ASSgSS611 bkfbk,�.:
A'�-��t4PROPERT.Y.'bW-Ntli'f3YCLAIMANTilWOTHER�COU?iT]ES�TC-i'�f W, �4W Z�
County
Twnshlp
County
nship
1 hereby certify the above statements are true, correct and complete.
Signature I clei
(number end street, city, state, ZIP code)
_0 v
if
N
'A"ASSgSS611 bkfbk,�.:
'A-TRLIE� TAX �,
��,SVAL'
0
OMESTEAD,�
:NON- RESIDENTIAL ,-,
Lesser of 12 Homestead
t-AT�100WOF,
Valuation or 535,000
$
66 063--
g 1 (one) acre immediately
Land not exceeding
1
surrounding residential improvements.
Otherland
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
. .......
Residential improvements or Annually
4 Ilk
Assessed Mobile I Manufactured Home
Garage
(5)
,�Ier improvements
(6)
Total Improvements (line 4 through line 6)
(7)
Tctal value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
AN
-ST D AR 01 DEDUCTION ALLOWANCE9�-,
20 _ Pay 20 _
Lesser of 12 Homestead
Valuation or 535,000
$
66 063--