HomeMy WebLinkAboutHomestead_Reisingei �'•, .
g CLAIM FOR HOMESTEAD PROPERTY TAX
s��� CREDIT/STANDARD DEDUCTION �
� State Form 5473 (R2 / 5-92) -
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INSTRUCTIONS: See reverse side for7iling instructions.
,e) � OI,II�JYl.q /QIY7.C2i' ��{- S.lJYJlA� /!/ - � certify.thai on the 1st day of March, 19�
�) occupied as our incipal place oi resid e the following'described real property for which,a Homestead Property Tax Credit is hereby claimed:
G�We) owned ❑ Are buying under contract � � �. � � � �
❑ Have a beneficial interest in the entity ihat is liable for ihe property taxes on ihe property and that owns ihe property or is buying under a contract.
If buying on con�raci,
Recorder's office where coniract
Caunry
owner's name
Parcel number I
Cb5 Q0�37-�
If any portion of the residential sVUCture or ihe
of ihe property utllized ro produce income.
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PROPERTY DESCRIPTION
eaceeding one(1)
P� ��5
town;
IhalSWCiure is used to produce inCOme. destribe Ihe u5e and potlion
Qo��
PHOPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
certify ihe above statements are irue, correct and compiete.
number and street, dry. state. Z/P mde)
T6 � x 3� 4 8 0�,�.�.�,.,;,(�.
ot Gaimant
ASSESSOR USE ONLY . TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL. -
- VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding resideniial impmvemeMa (�) -� "
Otherland (2�
Total land (line 1 plus line 2� (3�
Dwelling (4) .
Residential improvements
Garage (g) '
Other improvemenis (6) _
Total improvements Qine 4 through line � (7)
Tota1 value (line 3 p�s line � (g)
1 hereby certily the above is INe. Correci, and Signature ot Assessor Date signed
complete.
, virg adion - Signature of Auditor Date si9netl
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