HomeMy WebLinkAboutHomestead_TimberlakeCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION.
• i. State Form 5473 (R2 15-92)
INSTRUCTIONS. See reverse side for filing instructions.
FORM
HC10
YEAR
�- CERTIFI TION TATEMEN .
I the 1 ''di 19_
ftvvTT,,S5thA�1a``t
(We) on rch,
I (We) occupied as our of residence the following described real property for which a Homestead Pfuifryoq C2mg hereby claimed:
principal place
E) I (We) owned E) Are buying under contract LUUU
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that ow` erty is 0uving under a contract.
CONTRACT RECORDED LU"ITCn J
If buying on contract, Fee Simple owners name r
Recorders office where contract is recorded I
Record number
Page
PROPERTY DESCRIPTION'
County
Township
Taxing o' a wit, s )
Paroel number
Legal description
3
gel- X74-00
02
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to prod• ce income, describe the use and portion of
the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County -
Township
ereby certify the above statements are true, correct and complete.
Signature of daimant
/j�v -� r
dd as (nuplUer and street, city, state, ZIP code)
303
ASSESSOR USE ONLY d
TRUE AX
ASSESSED
HOMESTEAD
NON- RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Otherland
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
hereby certify the above is true, correct, and
Signature of Assesor
Date signed
complete.
Verifying action - Signature of Auditor
tDtesigned
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
$
Valuation or 52,000
Sign, f ditor
Date sign D 1�—n O