HomeMy WebLinkAboutHomestead_Armstrong; ���`'��" - CLAIM FOR HOMESTEAD PROPERTY TAX
�. CREDIT/STANDARD DEDUCTION
i State Form 5473 (R2 / 692)
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6
INSTRUCTIONS: See reverse side lor filing instructions.
FORM
HC10
YEAR
ERTIFICATION STATEMENT �.' �^y _pp �, :� � � - �; �
I(VJe) certi t at o��4s ar� ,, 19_
I(VJe) occupied as our principal pl c of residence the following descnb ai property for which a Homestead Property Tax Crdedit is hereby claimed:.
❑ I(We) owned ❑ Are buying under contract f t d Q`� �000
b P P�h' P P hY P P hY �Y 9� ��
❑ Have a beneficial inierest in ihe enti that is liable for the ro e taxes on the ro e and that owns the ro e or is b�in der a contract.
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- CONTRACT RECORDED " /!I _ipSn�, -� - � �'7 � � ""�
It buying on wntract, Fee Simple owners name
Remrdefs office whe2 contract is recortled Record number Page
PROPERTY DESCRIPTION
Counry Township Tawng tlistrict (ciry, town, hip) �
Pa�� b�_ � O�� Legal tle Ptl � �� n ��� I�
L
It any ponion of the resitlential structure or the land not e:ceeding one (1) acre thai immediatey surtounds that siructure is used m protluce income, tlescribe ihe use and portion of
the Property utilizetl to produce income.
G�G -/�- ra'/- o30D - G4�o? . GG� Do3.� .
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County - Township Counry Township
S" t e ot claimant
.•ereby certify the above statements are true, correct and complete. - -
Address�umbera�streeL ciy, stafe, ZlP e _ � N' ,)
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ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediatety - (��
surrounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvements
Garage (5)
Other improvements (6)
Total improvements (line 4 thmugh line 6) (7) �
Total value (line 3 plus line 7J (8)
I hereby certity the above is true, conect, and Si9namre of assesor Date signed
complete.
Verifying ac6on - SignaNre oi Auditor Date signetl
. � STANDARD DEDUCTION ALLOWANCE
-- 19_ Pay 19 _
Lesser of 1/2 Homestead �
Valuation or 52,000
Sig ture f Audi Date si ned
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