HomeMy WebLinkAboutHomestead_Hill (2)y CLAIM FOR HOMESTEAD PROPERTY TAX
e CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
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INSTRUCTIONS: See reverse side for filing instructions.
• /\ . ' %- DERTIFICATI
FORM YEAR
HC10
certify that We 1st daylbt`bYarch, 19
N,e) occupied as our principal place of residence the following described real pro - ,Property Tax CreditT hereby dai'm/ed,
I (We) owned El buying under contract —'! ✓ c�
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the propertyor Is buying under 'a contract.
Recorder's office
.i
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES - -
'
PROPERTY DESCRIPTION
County
Township
�?reby certify the above statements are true, correct and complete.
n t imam
Taxing ist city, town, t wnship)
P I number
Mr- 03�
Legal de
ti n
1d
base Coro
It any portion of the residential structure or the land not exceeding o e 1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
- - v 0 50 3 -0G
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES - -
Counry
Township
County
Township
�?reby certify the above statements are true, correct and complete.
n t imam
VALUE
VALUE
Address (number and scree ryOs(a 10 (/
21 / /�J i l�
C
Vj
L 11
ASSESSOR USE ONLY
TRUETAX
ASSESSED
HOMESTEAD
NON-RESIDENT ULL: ,
-
VALUE
VALUE
VALUE
VALUE_
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
- �-
Other land
(2)•'
'
a.4
Total land (line 1 plus line 2))
(3)
Dwelling
(4)
1�
Residential improvements
-' -
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
- - STANDARD DEDUCTION ALLOWANCE'
19 _Pay 19_
Lesser of 1/2 Homestead
$
Valuation or $2,000
'
S Audi r
Date - . etl ' /
�/ t", 19
�7