HomeMy WebLinkAboutHomestead_Nurrenbern (3)i n�p
ea a CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT/STANDARD DEDUCTION HCio
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,,�p .,;� State Form Sa73 (R2 / 5-92) .
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INSTRUCTIONS: See reve�se side lorliling instmctions.
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' � . ' CERTIFl TION STATEMENT . -
I(We) - certify t on the tst day March, 79_
�e) occupied as our princi I lace of residence the following descr' ed real property tor which a Homestea roperty ax G�edi \ hereby ai
�, I(We) owned ❑ Are buying under contraci � r'���'�` ��%' ?`+ '�! ��I70R
❑ Have a beneficial interesi in the entity that is liable for the property taxes on the pmperty and that owns the property or is buying.under a contraci.
� • � � CONTRACT RECOHDED � - � . ` � �
tl buying on contract, Fee Simple owner's name
Recorder's ottice where contracl is recorded � RetOrd number Page
PROPERTY DESCRIPTION
Couniy Township Taxing distnct (ciryrt wn row ip) .
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Parcel number Legal de rip � n
o i- ooa� -� �( a 7
If any ponion of Ihe residential simcWre or ihe land nm exceedinq one (1) acre that immetliarety surmund�th structure is usetl m produ income, describe [ e use:
ot �he properry uGlized Io produce income.
ASSESSOR USE ONLY� TRUE TAX ASSESSED HOMESTEAD . NON-RESIDENTIAL
� , .VALUE� VALUE. VALUE . VAWE
Land not exceeding 1(one) acre immediately �
surrounding resideniial improvemenis. (�� � "
Other land . (p)
iotalland Qine 1 plus line 2� (3)
Dwelling (4) �. � -
Resideniial improvements �
� Garage (5) � �
Other impmvements (6) -
Total improvements (line 4 through line � (7)
Total value Qine 3 p6s line 7� (g)
I hereby Certi�y the above is true, CorreCt, and Signature of Assessor Date signed
complete.
Veritying action - Signature of Auditor - Date signetl
STANDARD
19_Pay19_
Lesser of 7/2 Homestead
Valuation or 52.000
sign
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