HomeMy WebLinkAboutHomestead_SchnautzI (We)
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (Re 14-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
as our principal place of residence the following described real
I (We) owned ❑ Are buying under contract
FORM YEAR
HC10
certify that on the 1 st day of March, 20_
for which a Homestead Property Tax Credit is hereby claimed:
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
>iRECORDE
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If buying on conVaot, Fee Simple ownefs name n
Recorder's office where contrect is recorded d num Pa r
r•I c r inqog
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�s .;:�.Y,'e:'- "�..rt�r�P,ROP,ERT, 40ESCRIP.TION- of -+�'�
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County
Township
Taxing district ( ,own to
S,grjgVre of claim nt
Parcel nober_ O rte/ o
(� UX
Legal description
Is the pmperty i�tion:
Real property ❑ Mobile Homo ( /.C. 6-1.1 -7)
If of tcoe 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
h property ufilized to produce income.
County
Tovnshi
u Townahip
hereby certify the above statements are true, correct and complete.
S,grjgVre of claim nt
Address (number and sheaf, city, state, ZIP code)
cz 6 v
R USEN • Y
TT+�
ASSESSE�DALl1E .
W 'TRUwE
LUEE
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VIAELSUTEEAD
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Y
*-NOLN;r.R.YEASLIUdE.EN'TxSIA�La,.9r . € *_
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Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
`} • �'•
a:.. �1:
Total land (line 1 plus line 2)
(3)
Dwelling
''�ig"'�`-'^r"'--�''t�'"Y'•�`'`
Residential Improvements or Annually
Assessed Mobile I Manufactured Home
Garage
(6)
` . —•
����??.' *1• sax` c,,.
MCI-
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
/
hereby certify the above is true, correct, and
Signature or Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed