Homestead_Crabtree (2)CLAIM FOR HOMESTEAD PROPERTY TAX
i� CREDIT /STANDARD DEDUCTION
State Form 5473 R215-92)
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INSTRUCTIONS: See reverse side for filing instructions.
/1 .. .- „,.CERTIFICATI
FORM YEAR
HC10
I IWe) J I._.�.(_.� -rl-a `/S,[]L TL_JV tKx� certify that on the 1st day oWarch, 19
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'e) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Cre�dit�g ereby trim
LJ I (We) owned ❑ Are buying under contract GI8SOta C`J,li `TY AUDITOR
❑ 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.
w 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
NON - RESIDENTIAL. ,
Taxing district (dry, town, township)
P/ar�cel n�umfxr %%
Legal description
S D �
It 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.
Q -
-
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
-
Tow
County nship
County Township
NON - RESIDENTIAL. ,
reby certify the above statements are true, correct and complete.
` atgr I nt
VALUE
VALUE
- VALUE
i
Address (number and street, city, state, ZIP code)
/ 1 • ' r
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL. ,
VALUE
VALUE
VALUE
- VALUE
Land not exceeding 1 (one) acre immediately
-
surrounding residential improvements.
Other land
(2)
Total land (line I 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 pfrs line 7)
(g)
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1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
tying action - Signature of Auditor
Date signed
Signature of Auditor
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STANDARD DEDUCTION ALLOWANCE =
19 _Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000 S
Date signed
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