HomeMy WebLinkAboutHomestead_DyhouseCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION I
State Form 5473 (R614-03) V
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
ERTIFICATIONISTATEMENT�',�t
I (We) V\ JLQ-9N'^� certify that on the 1st day of March.
I (We) occupi as our prindpal place of residence the fol ng described real property for which a Homestead Property Tax Credit Is hereby claimed:
gQ'k"e) t ❑ Are buying unde.m..., t-
WHave 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.
Tf
'Z� k�f�VC-�
��;-�,'�-Z-�tlir-�,CONTRACT-RE.CORDEDI--�
If buying on contract, Fee Simple owners name
Recordees office where contract is recorded Record number Page
PROPERTYDESCRIP-:rION:kg.?`'t.-:
County
Tawnstrip
Township
T==? tidatlamlhp2i-�
Signature of claimant
Parcel number
0
Lega
ton
M, SX
0V�: VALLI E
is thiprop.4jir don;
- 00 13 36 -9y.
I .11
Wpiroperly ❑ Mobile Home (I.C. 6-1.1.7)
lot s Portion of the residential structure or the land not exceeding we (1) am
that imrhediately itumounds that structure is used to produce Income, describe the use and portion
f t1h property udlized to produce income.
Other land
(2)
LWI
�.SSESSOR.,USgONLY�.*,�I
County Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant
ress (number and street, city, state, ZIP code)
V
�.SSESSOR.,USgONLY�.*,�I
R AX j'�
TRUE T
i!
ASSESSED GE
SS VALUE
-'AT-1
Lesser of 1/2 Homestead
...... —
NONIRESIDFNTLAL92'-'�'Cx
Valuation or 535,000
5N VALUE,.'_ -
0 0% 0 FjTTV
Date signed
0V�: VALLI E
Land not exceeding I (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
(5)
?;bru improvements
(6)
Total Improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct and
Signature of Assessor
Date signed
complete. -
Ventyvill action - Signature of Auditor
Date signed
STANDARD DEDUCTION' ALLOWANCE i,
20 Pay 20
Lesser of 1/2 Homestead
Valuation or 535,000
S
Signature of Auditor
Date signed