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HomeMy WebLinkAboutHomestead_Crowe'I CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT /STANDARD DEDUCTION State Fortn 5473 (R2 /5-92) INSTRUCTIONS., See reverse side for filing instructions. FORM HC10 YEAR CERTIFICATION STATEMENT I (We) certify that on the 1st day of March, 19_ I (We) oc upied as ou 'ncipal place of residence the following described real propert y 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. CONTRACT RECORDED If buying on contract, Fee Simple owners name Recorders office where contract is recorded Record number Page PROPERTY DESCRIPTION County Township Taxing district (cily, town, township) Parcel number o -©i 400- Legal description 1_3jCq 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. �G PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES County Township County Township ig ure of claimant Ste by certify the above statements are true, correct and complete. — A dress (number and street, city, state, ZIP code) a, R ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON - RESIDENTIAL VALUE VALUE VALUE VALUE Land not exceeding 1 (one) acre immediately (1) surrounding residential improvements. Otherland (2) Total land (line 1 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 plus line 7) (8) 1 hereby certify the above is true, correct, and Signature of Assesor Date signed complete. Verifying action - Signature of Auditor Date signed STANDARD DEDUCTION ALLOWANCE 19_ Pay 19 Lesser of 1/2 Homestead S Valuation or $2,000 Signature of Auditor Date sjgped L lf/1 ^d %l