HomeMy WebLinkAboutHomestead_Powello•—^-:'a -
e/ g CLAIM FOR HOMESTEAD PROPERTY TAX
i��� CREDIT/STANDARD DEDUCTION .
,�<� State Fortn Sa73 (R2/5=92)
FORM YEAR
HC10
INSTRUCTIONS:
TIFlC ION STATEM � . ^ � ' � ' ��
I( e) certify.ihat on th t y� Ma� 9�
It
pied as principaf ace of sidence the following described real property for which a Homestead Pmperty Tax Credit is heretiy a�mc�
I(We) owned ❑ Are buying under contract , � �� �Y � 4 �998
I❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and thai owns ihe propert�or is buying.under,a oontract.
If buying on comraa,.Fee Simple owner's name
Recorder's office where contract is recorded
Counry
Ii any
of Ne
Counry
of
COMRACT RECORDED
v�o5�?:Y
Retord number � Page
- ' PROPERTY DESCRIPTION - ' �-
' � . � Township "' - . " Taxing district iry, wn o nsh" ) .
T Legal tlescription . .
U
�idential stmcwre or the land not exceeding one (i) acre Ihat immediatey surwunds that swciure is used to produce income. describe the use arM portion
eo produce income. . , , .
PROPERTY OWNED BY
�by certify the abovestatements are true. correct and complete.
Addresslnurrpe/aadf:ceeGCip!$are.ZlPcoq¢l. /1 .
` ASSESSOR USE ONLY
Land not exceeding 1(one) acre immediately
surrounding resideniial improvements.
Other land
Total land (line 7 plus line 2�
Dwelling
Resideniial improvemenis
Garage
Other improvements
Total improvemenis Qine 4 lhrough line �
Total value (line 3 p�s line 7�
I hereby certify Ihe above is irue, correci, and
compiete.
�`'virg action - Sgnawre of Auditor
79_Pay19_
Lesser of V2 Homestead
valuation or 52.000 �
—Wi. /UJ'l/OJ✓
7LAIMANT IN�OTHER COUNTIES
Counry
TRUETA7C I ASSESSED
VALUE VALUE
(�)
(2)
(3)
(4)
(5)
(6)
l�)
(8)
Signature of Assessor
S
HOMESTEAD
VALUE
Township
' NON•RESIDENTIAL
VALUE
Da;e signed
Da:e signed
SgnaWre of Autliror � Date