HomeMy WebLinkAboutHomestead_Pfohle�% �°� CLAIM FOR HOMESTEAD PROPERTY TAX
ar� CREDIT/STANDARD DEDUCTION
,��' State Form 5773 (R2 / 5-92)
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INSTRUCTIONS: See �everse side !or 7iling instructions.
FORM YEAR
HC10
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Ne) � '""—`� certify that on ihe 7st da'y of'March, 79_
�'e) occupied as our principal place of residence the following described re operty for which a Homestead Property Ta��Cry i�syerp¢y��laimed:
❑ I(We) owned ❑ Are buyinq under contrect IyJ,
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❑ Have a beneficial interest in the entiry that is liable for the property taxes on the property and thai owns the property or is bu`ing,under a contraci. r
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�� GIBSO*' c'�Ath1TY �ttD�ra't 1
�- . . . . . - -. CONTRACT RECORDED' °. - • - - . ; ,,. ` � .
If buyi� on contract, Fee Simple owner's name
Fecortler's oHice where contrad is recorded Record number Page
�a,�,� �9� ��o���.
If any portion of Ihe �rsmennai strudure or the land not
ot the properry utilized m produce income.
PROPERTY
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g-3 -/o s. o � t�C'
wnoufMs that struaure is used to protluce income. describe the use and portion
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,. -� qSSESSOR USE ONLY ' � TRUE TAX ASSESSED HOMESTEAD , NON-RESIOENTIAC. ,
� - . � � � � VALUE .VALUE�.� VALUE VALUE �-�-
Land not exceeding 7 (one) acre immediatety (�) � _ . ' . � � �
surtounding residential improvements. �
Otherland (2) �
Total lantl (line 7 plus line 2� (3)
Dwelling (4) .. ' � � ,
Residential improvements .
Garage (5) _ � .
Other improvements (6) � �
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � (g)
I hereby certity the above is true, correci, and Sgnamre ol Assessor Date signed
complete.
�(g action - Sgnamre of Auditor Date sgned
19_Payt9_
Lesser of 1/2 Homestead
Valuation or $2,000
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Date sign9d �� � �
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