HomeMy WebLinkAboutHomestead_Short (3)I� r; CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
\ � State Form 5473 (R61403;
Prescribed by Ne Department d Local Govemment Finance
INSTRUCTIONS: See revcrac side Ior lilinq mslrur,hnus.
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I (VJe) \
I(We) occupied as our pri ipal place of residence the f Ilowing descnbed real property for which a Hom�
❑ I(We) owned Are buying under contracl
� Have a benefidal interest in the entity that is liabie for the property taxes on the property and that owns
If buying om m�ireU. Fee Simple ownets name
Recordefs otfice where contract is recorEed
FORM YEAR
HC10
�' $� �_ " _ . .
y Hiat�n(}nd�st day ot Mamh, 20_
1
i Property T�c Credit is hereby daimed:
���g�G�nder a conVact.
b:�_�.,._ ... . .
�N Tawnship Tacing district (c
/�� � D/ Legal Cescription Is the
�CJ
It any portion ot ihe resitlential sWCWre ar the Wnd not exceeding ane (7) acre Nat immediately wrtounds
ot the properry utilizeA m produce income.
07�-/%O/- OQ-�J0.3. 7a/-�J�/
Rewra num6er
Page
queslion: U
teal pm0erty ❑ Mabile omo (I.C. 67J-7)
re is used lo produce income, describe tha use and portion
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�� �N � r��';��� � '$ � � � � -.�TRUETAX ASSESSEDVALUE �:�HOMESTEAD'' � NON-RESIDENTIAIL �
. ;�.,
y:: }=i`ti4 ` ASSESSOR USE ONLY_ _ . _: � .'� . . • VAI.UE � AT 100%�OF,TTV; �S ' VALUE��, -'�,i,� ., ',�.:=1; VALUE i . `.,'` �
..,. s."_
Land not exceeding 1 (one) acre immediately - -; -; =r�:;';"i ,""". - -
surrounding residential improvements (�) -, .. �_ .. '
Other land (2) � - � ' . -
TRaI land (lina 7 plus line 2) �3)
Dwelling (4) ' �{ c, . .:- .` ..�..
`f »:i 2:: ' �sr.:,. _ :;.sr't:>[ . '
Residenliel improvements or Annually . , _
Assessed Mobile / Manufactured Home Garage �g) ` . �
Other improvements (g)
Tual improvements (line 4 fhrough line 6) (�)
TUaI value (line 3 pha line n (g)
I hereby certiy the above is true, cortect, and S�gnawre ot asseswr Daee signed
camplete.
Ventying action - SignaWre oflwaimr Date signed
-:-�§:°:z;::i-�. � �� "= -.STlWDARDDEOUCTION
20 _ Pay 20 _
lesser of 1!2 Homestead
vzivauon or 535.000
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