HomeMy WebLinkAboutHomestead_Becker�E mn '
d� �a CLAIM FOR HOMESTEAD PROPERTY TAX .
i��'� CREDIT/STtiNDARD _DEDUCTION
.�:,�'� State Form Sa73 (R2 / 5-92) .
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INSTRUCTIONS: See �everse side lor liling instructions.
. .. � _ � . .. � . _ .. - y-wonnnrnnnu crn�
FORM - YEAR
HC70
I�we) - � W �, ceniy thai on the 1st day of March, 79
�) occ ied as our princi I place of residen e e Ilowing described real property�for which a Homestead Property Tax Credit is hereby daimed:
I� (We) owned ❑ Are buying under conir � . • �j ��
tl1
❑ Have a beneficial interest in the entity that is liable for ihe property taxes on the pmperty and that owns the propErty __ i_u� u�ia ntract.
It buyirg on contract, Fee Simple owners name
Fiecortler's oHice where contract is recorded
- � PROPERTY DESCRIPTIO � `
Counry ' � Township � - Taxing di5lri (C y. (own, to�Tnship) . � � . .
' ber Legal tlescription
�'�' �0�23- � �
If any portion of ihe residential stmcture or lhe land nat exceeding one (1 � acre thai immediatety surrountls that structure is used to produce income, descnbe the use and portion
ot the property utiized ro produce income. „
c�-/9-.3o-f�-dc�.3�3=6a�
� PROPERTY OWNED BV CLAIMANT IN�OTHER
Counry Township nry
,eby certity the above statemenis are irue, correct and complete. � Si amre ot ai �
Address (number antl streel, ciry, sfate. ZIP code)
ASSESSOR USE ONLY
Land not exceeding 1(one) acre immediately
surrounding residen[ial improvements.
Otherland
Total land (line 1 plus line �
Dwelling
Residential impmvements
Garage
Oiher improvements
Total improvements (line 4 through line �
Total value (line 3 p�s line �
I hereby cenify ihe above is true, correct, and
complete.
.vs�ying action - Sgnature of Autlitor
19_Pay19_
Lesser of t/2 Homesiead
Valuation or 52.000
TRUETAX ' ASSESSED
VALUE - VALUE.
lU
l2)
(3)
(4)
(5)
(6)
(�)
18)
Signature of Assessor
S
HOMESTEAD
VALUE
Tovmship
NON-RESIDENTIAL
VALUE
signed
signed
�S=nature ol AudiIDr � /� �l /� / � � -
"� 1 / l�Xv�'
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