HomeMy WebLinkAboutHomestead_Wagnerdd a CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5-92)
raiJJJ
See reverse side for filing instructions.
occupied as our princikhl place of residence (17k following described
'FEB 2 2 1994
�Z, rtify. that on the 1st dAUDWOR9
a Homestead Property Tax Credit is hereby claimed:
l(We)owned ❑ Are buying under contract
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 under a contract.
CONTRACT RECORDED
If buying on contract. Fee Simple owner's. name
Recorder's office where contract is recorded Record number Page
- PROPERTY DESCRIPTION -
County
Township -
Taxing district (city, town, township) - -
Parcel num er
Legal descripI
It any portion of the residential structure or the land not exceeding one cre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township _-
County
Township
taby certify the above statements are true, correct and complete.
u of ai
A tlr s (number and street, city, state. ZIP code)
7 do o A oXA-i- 0 c-1711 4/ ) 6�O
FA
ASSESSOR USE ONLY
TRUE TAX
.VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pbs line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
�fying action - Signature of Auditor
Date signed
r-
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or S2,000
DEDUCTION ALLOWANCE
S
Date