HomeMy WebLinkAboutHomestead_Williams (13)y`�rt�� � CLAIM FOR HOMESTEAD PROPERTY TAX
>> '� CREDITISTANDARD DEDUCTION
� State Form 5473 (R2 / 5-92)
s � �
INSTRUCTIONS: See reverse siUe lorlilrng instructions.
FORM
HC10
YEAR
. � °.. . .. ` . -..CE TtFlCA Sin7euse►�i:-. .: _.--°- ,..-. , .. ...._ . . .
�e) certity that on the 1 st day of March. 19_
occupied as our principal place of residence the tollovnng described real property for which a Homestead Prop`ert'�Tax'Credit is heietiy daimed:
I(We) owned ❑ Are buying under coniract �����
❑ Have a beneticial interest in the eniiry that is liable tor the property taxes on the property and that owns ihe property or is buying under a contract.
I � _ PROPERTY DESCRIPTION/i.' , � ,-. �`--_'- `� . „ " " I
Counry Township Taxing distr ( � _ , wnshrp) _ t..� ^ � ^ /l I
�_I 1 ' l�)v�n I�VLJ
If any pomon of the residen6al s[ruaure or the land not eaceetling one (t) aae
oi Ne property utilized to produce income.
Counry
sunounds ihat struc[ure is used to produce
OWNED BY CLAIMANT IN OTHEP COUN7IES
�ereby certify the above statements are true, correct and complete.
Address (number arM streef, ciry, state. ZIP�ode) �� �
ASSESSOR USE ONLY �
Land not exceeding 1(one) acre immediately
surrounding resideniial improvemenis.
Oiherland
Total land (line 1 plus line �
Dwelling
Residential improvements
Garage
Oiher improvements
Total improvements (line 4 through line �
Total value (line 3 p�s line 7)
I hereby certify ihe above is irue, correct, and
complete.
�:vim action - Sionature of Auditor
19_Pay19_
Lesser of 1I2 Homestead
Valuation or $2.000
TRUETAX
VALUE
(�)
(Z)
(3)
14)
(5)
(6)
(�)
(8)
Signamre ol Assessor
Signature ot
5
ASSESSED
VALUE
HOMESTEAD
VALUE
a '
tlesCnbe �he use antl portion
NON-RESIDENTIAL.
VALUE
signed
siqnetl
5'gnatureolAUtlitor .IDatesignetl _