HomeMy WebLinkAboutHomestead_Williams (4)�� n�� ' � .
e� " g CLAIM FOR HOMESTEAD PROPERTY TAX
za�� CREDIT/STANDARD DEDUCTION
�:;;� State Form 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side 70� 7iling instructions.
" FORM YEAR
HC10
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I IWe) � . � certify that on the 7st day of March, 79 -
��) occupied as our principal place esidence the foliowing described real property for which a Homesiead Property T redit i e�bY qT�q��rs
[� I (We) owned ❑ �nre buyin9 under contract � . _ AUDITOR ��
❑ Have a beneficial inierest in ihe entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
� � •� � � � - � .CONTRACTRECORDED� � - ' ��. �
It buying on conlraG, Fee Simple owner's name '" � . _' '
Recortlefs office where contraa is recorded Record number Page
County -
Township
Legal tlescription
PROPERTY
_ � .
fawn.
CJI�JJ ' V IJ�'(6 —� I 'j' � dl.�.l T(O ' J— l t- �'� E/ 1"i L.
If any ponion of the residential structure or the IaM not exceeding one (7) acre that immediatey surrounds that strucWre is used to produce income, descnbe Ne use and portion
oi Ne property utilizeC to produce income.
'-OG-3o3-c�/S92-o�
� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Couniy TownShip Counry TownSNp
�eby certify ihe above statemenis are irue, correci and complete. � nawr o� ciaimam �
Atldress (number and slreet. ciry. slafe, ZIP wde)
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ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL �.
. VALUE VALUE VALUE VALUE
Land noi exceeding 7(one) acre immediately
surrounding residential improvemenis. (�) �
Otherland (p)
Total land Qine 1 plus line 2� (3)
Dwelling (4)
Residential improvements
Garage (5� - �
Other improvemenis . (6)
Total improvements (line 4 through line � (7�
Total value (line 3 pVs line 7) (g�
I hereby certify the above is Irue, correct, and Sgnamre ot Asseswr Dare stgned
complete.
V�g action - Signature of Auditor Date si9netl
79_Pay19_
lesser of 1/2 Hdmesiead
Valuation or 52.000
SiqnaWre of Audiror
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Date 5igpetl � � L1� I -
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