HomeMy WebLinkAboutHomestead_SpeicherM
Nn CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION Hc�o
S State Forth 5473 (R4 / &00)
INSTRUCTIONS: See reverse side for filing instructions. G 9 T 17 N N
I (We) \ ILYS iJ0 VLJr✓. Z4 01 l faL certify that on thqIs d'ay of 1G1a�rch, 20_
I (We) occupied as our principal place of residence the following described real pro erty for which a Homestead P operty Taz Credit is'rw retry daimed:
❑ 1.(We) owned ❑ Are buying under contract
rn:��gg ((11 pp pp
Wave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the propQgS is �uying under a IwOntrad.
C6NTRKg1!_ECORDED
If buying on contract Fee Simple owner's name -
Recorder's office where contract is recorded - Record number Page
i — T- -r- 0-�—T,—
PROPERTY OWNEDjBY:CLAIMA TIN OTHER COUNTI_ESz
County - Township
County Township
hereby certify the above statements are true, correct and complete.
County
Township
Twing district (city, town, township)
Parcel number
Legal description
—
_
/the -I1use
If any portion of a residential structure or the land not exceeding one (t) acre that immediately surrounds that structure is used to produce income, describe and portion
of the property utilized to produce income.
Total land (line 1 plus line 2)
(3)
i — T- -r- 0-�—T,—
PROPERTY OWNEDjBY:CLAIMA TIN OTHER COUNTI_ESz
County - Township
County Township
hereby certify the above statements are true, correct and complete.
Sc a 'ma
Land not exceeding 1 (one) acre immediately -
surrounding residential improvements.
-Add (n er et, city, state, IP code
qw. \ , v
�- w -'$- .t'
ASSESSOR USE ONLY, s
TRITE r {
ASSESSEDaVAL7UE
z
00Y, oyOF .3TiN._.r1`-
I"�'��NOMESTEAD
VpUEt4"_- S-
rr NONE= SIDENTIAL _
,`.tea. -� `5+d^sVALUE- ..... .
Land not exceeding 1 (one) acre immediately -
surrounding residential improvements.
''-'-K! '` v -
� ✓��
Other land
(2)
arr-i
R
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
�,_�
;e�r � ' --
Garage
(5).
G ��,.5
Other improvements
P
6
()
� '
m
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed