HomeMy WebLinkAboutHomestead_Lienemann� rt�n CLAIM FOR HOMESTEAD PROPERTY TAX
�� � CREDIT/STANDARD DEDUCTION
s State Form 5a73 (R2 / 5-92)
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INSTRUCTIONS: See reverse side lor /iling ins7uctions.
'�'?�" ?"'' FORM YEAR
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DEC 3 e 2009
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'We) _ � /S �C �C ��� Al�liiy-mat on the 7st day.of Mar,ch, 19,
Je�) occupied as our principal place of residence the tollowing described real property for which a Homestead Property Tarz Credii is hereby claimed
Cvl (We) owned ❑ Are buying under mntract MAR 19 199g
❑ Have a benefici �nierest in the entity ihat is liable for the property taxes on the property wns ihe property or is buying ur�der a contract.
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_ . � . - _ _ _. . . . .. �CONTRACT RECORDED . �. . ,. �>, °, _ --- �;•.••uy[tt Y A�aC1791�.;,.
Page
. . � � , - PROPERTY DESCRIPTION� � � . � �' -"- - � " ' .
Counry � Township Taxing distrid , own, t shrp)
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Pa/rce�l number 1 Legal descnption �� /� � —// / � ��
W� d �
If any portion ol Ihe residential s[ruaure or �he land not ezceeding one (1) acre that immediately surmunds �hat structure is used to produce income, describe the use and portion
ol the property utilized to produce income.
01�—//-/'/- iQ�-cY1� 37a—�a?
PROPERTY OWNED BY CLAIMANT
Township Counry
certity the above statemenis are true, correci and complete. Signam
2uq�ber arrd streeC ciry, sfare. ZIP code)
� ASSESSOR USE ONLY ` TRUE TAX ASSESSED HOMESTEAD � NON•RESIDENTIAL'. �
� VALUE VALUE VALUE VAWE � �
Land nm exceeding 1(one) acre immediately - � - °
surrounding resideniial improvemenis. (�) �
Oiherland �2) ' -
Total land (line 7 plus line 2� (3) �
Dwelling (4) . � � . � .
Residential improvements -
Garage (5) , -
Oiher improvements (6) �
Total improvements (line 4 thmugh line � (7)
Total value (line 3 pfrs line � (g)
I hereby Certify [he above i5 irue, Corrett, and Sgnamre of Assessor Date signed
complete.
�nrilyirg aIXion - Signature of Audilor Date signed
19_Pay19_
Lesser of 7/2 Homestead
Vaivation or $2.000
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olAuditOr � � uacesqneo
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