HomeMy WebLinkAboutHomestead_Miller (9) a +�'\ CLAIM FOR HOMESTEAD PROPERTY TAX - FORM YEAR _.
CREDIT/STANDARD DEDUCTION HC10
State Form 5473(R2 I 5-92) '
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INSTRUCTIONS:See reverse side for tiling instructions.
- • CER I N ST T ENT '
I(We". _ certify that on the 1st day of March, 19
1 •upied our principal place of residence the following described real properly for which a Homestead Property • t r t ere Limed:
,,,❑ 1-(We)owned ❑ Are buying under contract u :. • 1.•
@ 0 Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying un er . . ,.,. •
JUL 2 5 1996
CONTRACT RECORDED an. Air s/.���`�''
If buying on contract,Fee Simple owner's name '�� L�,�'�V
AUDITOR
Recorder's office where contract is recorded I Record number I Page
PROPERTY DESCRIPTION •
county Township Taxing district(city, in,t nship)
e
Parcel number Legal description
011 -0.1o`-V$-co - CAN _..91-4-49--4-
If any portion of the residential structure or the land not exceeding o1 ).3L1)
r acre that immediately surrounds that structure is used tV-f -6Q
ce income,describe the use and portion
of the property utilized to produce income.
Pled. ,mom-,C._,k —� 'VNI.-. aft- 1$ ati - aOz -'1m I . O98-Oa1.Q
-i-to alo-\g-at-A-ao\A- 10 \ • 't--k - 0aL0 . idg ,
,,,A.c.,6pc.01
cy\-‘20-4-4Nd .
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County I Township I C icxy I Township
Dip---+A„._4II
�t' •,certify the above statements are true,correct and complete. Signature of claimant
y t
Address(number and street,city,state,ZIP code)n
,c,._ '7005 S."- #'6 , cam Li' 7 (4It
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
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Land not exceeding t (one)acre immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line I plus line 2) (3)
Dwelling (4)
Residential improvements
Garage (5)
Other improvements (6) I
Total improvements(line 4 through line 6) (7)
Total value (line 3 pLis line 7) (8) 1
I hereby certify the above is true.correct,and Signature of Assessor Date signed
complete.
Verifying action-Signature of Auditor Date signed
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