HomeMy WebLinkAboutHomestead_Anderson (2)aE CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R215 -92)
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INSTRUCTIONS: See reverse side for filing instructions.
i0 r _ YEAR
FORM
i�ud r;i 19�t0
cam• F., �' ��'
-
. - CERTIFICATI N 1IIi1T0 STATEMENT -
1 n e) certify that on the 1st day of March, 19
; occupied as our principal place of re idenc t e following described real property for which a Homestead Property Tax Credit is hereby claimed:-
❑ I (We) owned ❑ Are buying under co ct _ -
❑ 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.
CONTRACT RECORDED '
It buying on contract. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County' Township I Taxing district (dry, town, fgwnship)
• 1 7
Parcel number Legal description
005- c3gy�- -
If any portion of the. _.,.jai structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and
of the property utilized to produce income.
CIE — /0-43!_A0- 6)0o3.9�
` PROPERTY OWNED BY CLAIMANT IN O ER COUNTIES
County
Township
County
Township
®iy certify the above statements are true, correct and complete.
Sign ure of claimant
Address (number and street, dry. state. ZIP code)
ASSESSOR USE ONLY -
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or 52,000
Sg of Auditor Date signed
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plrs line 7)
(S)
1 hereby certify the above is true, Correct, and
complete.
Signature of Assessor
Date signed
vNing action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19_
Lesser of 1/2 Homestead
$
Valuation or 52,000
Sg of Auditor Date signed