HomeMy WebLinkAboutHomestead_Goodman (3)aE%�'� ; CLAIM FOR HOMESTEAD PROPERTY TAX
i!�� CREDIT/STAkDARD DEDUCTION , '
,�.` �� S�a;e Form 5a73 (R2 / 5-92)
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INSTRUCTIONS: See reverse side toi liling instructions.
FORM NEAR
HC10
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I��Ne) � i 1 r � Q re �J.�-�. � 7 0 wl !�/�� certify th n the 151 day ot arch, 19
�a) occupied as our principal place of residence the following described real property for which a Homesiead P erty Ta Cre it i reby cl e.
❑ I(We) owned ❑ Are buying under contract . �
� - � G9SON OU TY A.UDITOR
❑ Have a beneficial interest in the entiry ihat is liab�e for ihe property taxes on the property and thai owns ihe property or is buying under a contract.
� - " �� - CONTRACTRECORDED . . .
I( buying on contraa, Fee Simple owner's name . ' . �
Recorder's oHice where contract is recorded " Record number Page
County�l r
lJ
Parcel numb
PROPERTY DESCRIPTION
� . . Taeing tlis[n (Ciry. tov
- - y,(n �
UU'/-�� oZ/�o � � %01" o� �;�O t�� f�
If any ponion ot the residential strucWre or the IarM not exceeding one (1) acre ihat immediatety su
of ihe property uti6zed ro produce income.
— LYJ�03/(n � ��� .
used to produce i�ome, describe Ne use and portion
�� PROPERTY OWNED BY CLAIMANT IN OTHER COUMIES
County Townshi nty Township
` bso �-Q n � o
�eby certify the above statements are true, correct and complete. Sig t e or ciaiman
i i
Atltlress (numb anOStreef, ciry, sf te, ZlPcode) '
r---
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDEMIAL
VALUE� VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately
surrounding residential impmvements. (�) . �
Other land (p) .
Total land (line 7 plus line Z� (3)
Dwelling (4) � �
Residential improvements
Garage (g) � - �
Other improvements (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p6s line � (g) -
I hereby certi�y Ihe above i5 true, rArrect, and . SignaWre of Assessor Date signed
complete.
��+yirg action - Signature of Auditor Date signetl
19_Pay79_
Lesser of tl2 Homesiead
Valuation or 52.000
of Auditor
S