HomeMy WebLinkAboutHomestead_Davis (3)V °'° CLAIM FOR HOMESTEAD PROPERTY TAX R
CREDIT /STANDARD DEDUCTION PU
State Faun 5473 (R6 / 7 -07)
•� nu. Prescribed by the Department of Loral Government Finance AUG 1 5 200
INSTRUCTIONS: See reverse side for riling instructions.
I (We) C� r /` 1_4Q Cron the COUNTY AUDITOR
certify tha on the 1st day of March, 20_
I (We) occupied as our principal place of residence 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.
Parcel number Legal descripti�on1 I Is the property in question:
S4) X3-1-1t 1 & 1 &/4 (- ❑ Real property ❑ Mob le Home (IC 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.
02& -of - a3 - Soo - o oo. y(-/o -01 8
County
Township
I hereby certify the above statements are true, correct and complete.
(number and street, city, state, and
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
-
Total land (line 1 plus line 2)
(3)
Residential improvements or Annually
Assessed Mobile / Manufactured Home
(4)
(4)
Garage
- -
-
�..r •1
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 pits tine 7)
(8)
1 hereby certify the above is We, correct, and
complete.
Signature ofAssessor
Date signed (month, day, year)
Verifying action - Signature of.4Lditor
Date signed (month, day, year)
pay 20
Lesser of 12
Homestead Valuation
or
Signature of Auditor
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012 $
43,000 for 2009 pay 2010 40,000 payable after 2012
signed (month, day,