HomeMy WebLinkAboutHomestead_Bottoms STATE REM 5I5MIR217A, TREASURER FORM TSIA
APPROVED BY STATE B ARD OF ACCOUNTS,:OW IRESCR®ED BY THE DEPARTMEVTpE LOCAL GOIFRI.>4T'MANIA CBI.I-_e.l
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
deduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead
•fraud causes higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the
homestead standard deduction to verify that they are eligible to receive the benefit and to provide
additional indentifying information necessary to allow county government to better monitor homestead
filings. This information will be kept confidential and can only be accessed by authorized county officials.
The Department of Local Government Finance will use this information to create tools that will help
county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Property Address(number and street,city,state,and ZIP code)
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State Parcel Number
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PART 2:TAXPAYER INFORMATION
Owner I • First Middle A Last
Mailing Address(numbe and street,city,state,and LIP code) %me as propeny address
:
Spouse First � Middle yr�Y" Last
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is
eligible to receive the homestead standard deduction on this property. Each undersigned also understands that, by claiming additional
homestead deductions unlawfully, he or she may be liable for back taxes and substantial financial penalties.
Own Signa re Date
PART 4: ADDITIONAL INFORMATION
i I ;11/
NOV 18 CU13
INSTRUCTIONS
r'.*_t CLAIM FOR HOMESTEAD PROPERTY TAX 1 R
�- CREDIT/STANDARD DEDUCTION -f �0 y �-{ tl
: State Form 5473(R8/7-07) JL l
Prescribed by the Department of Local Government Finance ✓/J��
INSTRUCTIONS:See reverse side for filing instructions. JUN 4 2008 / /6
_/ - CEERTIFICATION STATEMENT.[ _ - - _
•I(We) 10 `�' �/1 certify that®t6$eAk )AfDXar4N,CgdOR
I(We)occupied as our print I place of residen a the following described real property for which a Homestead Property Tax Credit is hereby claimed:
I(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.
•
If buying on contract,Fee Simple owner's name
Recorder's of5ce where contract is recorded Record number Page
'PROPERTY DESCRIPTION -
County TownsNp - Taring istdct(city;town,township)
Parcel number description / I Is the property in question:
7ri� 'i ❑ Real
property ❑ Mr'tile V` ,.1-71
If any portion of the residential structure or the land not exceeding(1),acre that immediately surrounds that structure is used to produce i
of the property utilized to produce income. 00 I -
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4/
arr.
•
. - _. PROPERTY OWNED BY CLAIMANT IN OTHER-COUNTIE - . - ..
County Township County Township
I hereby certify the above statements are true,correct and complete. Sig e i am_ /
it •mss(number end Street, stare�II''ZIPP��e) /G//�
X�f�C "nrJO C/l:fc_Ice , / q ye U
ASSESSOR USE ONLY ( TRUE TAX VALUE ASSESSED VALUE I HOMESTEAD ._1 -NON-RESIDENTIAL
AT 100%OF TTV .. VALUE ' � .VALUE
Land not exceeding 1 (one)acre immediately _ _ _
surrounding residential improvements. (1) .
Other land (2) .
Tctal land(line 1 plus This 2) (3)
I
Dwelling (4)
Residential improvements or Annually _ . . . .- _Assessed Mobile/Manufactured Home ^" _•
Garage (5)
Other improvements (6)
Tctal 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(month,day,year)
complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
1 . . . • STANDARD DEDUCTION ALLOWANCE , - ,•- -- --Y---
2 0 pay 20_ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 44,000 for 2008
Homestead Valuation pay 2009 41,000 for 2011 pay 2012 $
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor Date signed(month,day,year)