HomeMy WebLinkAboutHomestead_Hensleya%"-'"�°� CLAIM FOR HOMESTEAD PROPERTY TAX FoRM YEAR
;��'= CREDIT/STANDARDDEDUCTION ` ����� HCio ��'jy7
State Porm 5473 (R2/5-92) ��-�
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INSTRUCTIONS: See �everse side lor /iling instructions.
��B =�- ; 1996
I iWe o f f�Bba- ffE�vrc.a nuv� �v�. 9G
) . certify ihat on ihe 1st day of March, 79
�) occupi d as our principal lace of residence ihe following described real property for which a Homestead Property Tax Credii is hereby claimed:
V I(We) owned ❑ Are buying under contraci
❑ Have a beneficial interest in the eniity that is liable for the propeAy taxes,on ihe property and that owns the pmperty or is buying under a contract.
� - CONTRACTRECORDED � .
If buying on contract, Fee Simple owner's name • � � • � � - � ,
Recorder's oftice where contract is rewrded qecord number Pa9e
' PROPERTY DESCRIPTION '
Counry/ . . Tow/nsyh,ip Taxing district (city, mwq rownship). � .
C�//35a� /i/ONTfaory�b.0 - '
Parcel number Legal tlescription
bOS- O'3y6s'-oo �T NCeJ, n/E /� 3-/.Z /. %
I( any ponion of the residential stmaure or ihe land not exceeding one (7) aae [hat immediarety surmunds that strucwre is used m protluce income, describe the use and portion
of the pwpeny utilized to produce income.
� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Counry Township Coun[y Tawnship
eby certify the above statemenis are true, correci and complete. Signature ot claimam
.� c"
Addwss (number and s(reeC ary, srate, ZlP cotle)
/ Olu�..is ✓ cL� -Ls✓ SF7CvG Sl
ASSESSOR USE ONLY , TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
. VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvements. (�)
Oiherland (z�
Total land (line 7 plus line � (3�
Dwelling (4)
Residential improvemenis
Garage (g) ,
Other improvements (6)
Total improvements Qine 4 through line � (7�
Total value (line 3 pLs line � (g)
I hereby certify the abOVe is true, correCt, and Sgna;ure o( Asseswr Date signetl
complete. �
V�efifyirg action - Signamre of Audiror Date Signetl
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