HomeMy WebLinkAboutHomestead_Johnson (11)a��'`� a CLAIM FOR HOMESTEAD PROPERTY TAX'
x��: CREDIT/STANDARD DEDUCTION
�, ' State Form 5473 (R2 / S92)
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INSTRUCTIONS: See reverse side forliling instructions.
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YEAR
I IWe) / / / / certii o�}�S�f�Marth. 19
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�) occupied as our principal place of residenc he ollowmg described real property for which a eat�,P erty-Fav W�O�h�reby Gaimed:
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V I(We) owned ❑ Are buying under c n ct -
❑ 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 � - " � "
It buying on contracC Fee Simple owner's name
Recarder's oHice where contract is recorded Recortl number Page
Coun,y
P,ycet num� �
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It any portion of the reside.
of Ne properry utilized to p
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Township
` Legal description
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Slmtlure or Ihe IaM nOt exCeedinq
�ce income.
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PROPERTY DESCRIPTION
Tanirg di5(rici (city, town, Iownship)
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is used to pro3uce income, describe Ne use and portion
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES �
Gounry Township � Coun[y Township
�?by certify the above statements are true, correct and complete. ` Si9 ature t daimam
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Address (number and streef. dry, state, ZlP cntle) -
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ASSESSOR USE ONLY TRUE AX ASSESSED HOMESTEAD NON-RESIDENTIAL
� VALUE VALUE VALUE �.� VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvements. (�)
Oiherland (p) �
Total land (line 7 plus line 2� (3)
Dwelling (4)
Residential improvemenis
Garage (5�
Other improvements (6)
Total improvements (line 4 through line � (7)
Total value (line 3 pLs line � � (g)
I hereby cehity Ihe abOVe i5 lrue, cOrretl. and Signamre ot Assessor Date signed
complete.
Ventying action - SignaWre of Autlitor Dare signed
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19_Pay19_
Lesser of 1/2 Homestead
Vaivation or 52.000
STANDARD DEDUCTION
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Sgnamre of Autlitor � � uate sgnea ��
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