HomeMy WebLinkAboutHomestead_Tice`�'�" CLAIM FOR HOMESTEAD PROPERTY TAX
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' J' CREDIT/STANDARD DEDUCTION
� State Form 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side lor liling inshucfions.
FORM
HC10
YEAR
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CERTIFI N STA MEf1T •-'=^v .
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I(We) ce 'fy�apo � .y of March, 19_
I(We) occupied our principal place of residence the. followin escnbed real properry for which a Ho ead Prorp� O�aX,�redit is hereby claimed:
❑ 1(We) owned ❑ Are buying under contract �R L UU
❑ Have a beneficial interest in the enliry that is liable for the property tazes on the property and thai owns the property o- buyin nd a contract.
� CONTRACT RECORDED � ,;�:��: �'^iT0^ �
If buying on conVaM, Fee Simple ownefs name ^� ." "` "' -�
RecorCers office where contract is recorEed " - Recortl number Page
� PROPERTY DESCRIPTIO
County ' Tovmship Taxing distn ci fo , 7 Ship)
ParcglnuOmb����/�Legaldescn io � !7��—/� /' ��
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If any portion of Ne residential sWCWre or the land not exceedi� one (7) acre that immetliatety surtounds iha[ swc[ure is used to produce income, describe the use antl portion of
Ne properry uWized to O��uce inmme.
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PROPERTV OWNED BY CLAIMANT IN OTHER COUNTRIES
County Township � Counry Township .'
ot laimant I
�ereby certify the above statemen!s are true, correct and complete. '
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umber and streef, ciry, state, ZIP code)
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ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately �� �
surrounding residential improvements.
Other land (2)
To[al land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvements . I
Garage (5)
Other improvemenis (6)
Total improvemenis (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8) '
I hereby certity the above is true, correct, and Sgnamre or nssesor �are siqned
complete.
Veritying actbn - Signamre of Auditor Date signed
STANDARD DEDUCTION ALLOWANCE
79_ Pay 19 _
�esser of 1/2 Homestead c�
Valuatio r 52,000
Signawre di� Datesi ne , �^y�
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