HomeMy WebLinkAboutHomestead_Barrett (9)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION
State Form 5473 (R6 14-03)
Department by the Depertrrront d Local Government Finance
INSTRUCTIONS: See reveme dda for 18tp im&ucftm
I (We) � .�' U J < 449 A A _�_����1 4rtify ttilet attthg 1*Y of�ch, 20_
1 (We) occupied as our principal place of residence the following described real property for which a Homestead Prolg,e Tax r�)y� t hereby claimed:
❑ I (We) owned ❑ Are buying under contract 0 " 1 "'�
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.
If buying on mntrad, Fee Simple owner's name
where contract is recorded
Record number I Page
ti?iai? ,r"�z'�',�- :n.�`''�"'.`s'r „2 'jPROP,ERT.I?.-0ESCRIPTIDNry
County
County
Township
1 hereby certify the above statements are true, correct and complete.
Taring district (city, town, township)
P I number r I ^^
5-
Legal d plpt'ion `
�state,
'�'W+' -3"`r'
x -�"�`l AS5ESSOR�USE ONLY i ye -,
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-1
TRUEJAX( 3q
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Is the property in question:
") yO
G �J
Land not exceeding 1 (one) acre immediatey
surrounding residential improvements.
❑ Real property ❑ Mobile Homo (l.C. 6-1. 1-7)
If any portion of the residential structure or the land not exceeding one (t) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property Utilized to produce moome�y�
Other land
�%/
Ar'0 // `/� —/C0 ^ K/ 51 L6
.PROP.ERTY, OWNEDB B* ,CEAIMANT;IN'OTHER`COUNTIESM-tl-,�.�" Z,?-! 'a ?-i# ^.x`4 •k'
County
Township
County Township
1 hereby certify the above statements are true, correct and complete.
i atu of claimant r
ress (number and street, city ZIP code)�y
�state,
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x -�"�`l AS5ESSOR�USE ONLY i ye -,
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-1
TRUEJAX( 3q
i �YALUE w.SyFi
ASSESSED VALUE
AT 100 aTT/:
HOMESTEAD
r.VAwrza
N NAESIDENTIAL .
�VALUE.°�c,"�
Land not exceeding 1 (one) acre immediatey
surrounding residential improvements.
Other land
(2)
£ rrjr
yi - cif
Total land (line 1 plus line 2)
(3)
'Residential Impro vements or Annually
Aefttfined Mobile / Manufactured Hama
Dwelling
Garage
6
()
`� ��� �,
1 k ,
Other improvements
(6)
•Vr.YY
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(S)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Data signed
Verifying action - Signature of Auditor
Date signed
x;.ST/WDAR:DEDUCTIONfALLOWANCE -
20_ Pay 20_
Lesser of 112 Homestead
vauauon or (35.000
Signature of Auditor Date sign