HomeMy WebLinkAboutHomestead_Roberts (3)ea ^�� CLAIM FOR HOMESTEAD PROPERTY TAX
i��'�1� CR�DITISTANDARD DEDUCTION
�� State Form 5d73 (R2/ 5-92)
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INSTRUCTIONS: See reverse 5ide !oi liling inslructions.
FORM YEAR
HC70 �
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I(We) V V(/�+CY certlfy that on the 7 st day of March, 19_
I{wel�.eu as r rincipal place of residence the following described rea� pwperry tor which a Homestead Propeny Tax Credit is hereby claimed:
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�(We) owned ❑ Are buying under con�raci I�. �r li TT�i ,{�
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J Have a bene@cial interesi in the emity �hat is liable for ihe pwperiy taxes on the property and Ihat owns the propertgor is bu�ng�under aaco�act.
II ouying on contraa. Fee Simple owner's name
Re[Order's ofli�e where contractisrecorded
Counry
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CONTRACTRECORDED
PROPERTY DESCRIPTION
TownShip � Taxfng district (
Legal tlescrip�ion
Recortl
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II any portion of the residen;ial stmcmre or Ne land not e.ceeding one ( t 1 acre that immedla;ely su m ds �hat StmcNre is u§ed ro produce income. describe ihe
of �he pmpeny utilized to produce income.
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PROPERTY OWNED BV CLAIMANT IN OTMER COUNTIES
Counry � Township County �Tmvnship
cenity the above statements are true. correct and complere.
state. ZlPCooe)
av i �
Signaw^re o-t claimam /� � ,
� C.N �.��Q.(n f Jv''ii � � �
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Page
pOrtion
ASSESSOR USE ONLV � TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediarely
surroundinq residential improvements. (' �
Otherland I�p)
7otal land (line 1 plus line � (3) I I
Dwelling (c)
Residential improvements
Garage (5� I I .
Other improvements I (6) 1�
Total impmvements (line 4 through lina � (7) I ( I �
Total value (line 3 p�s line 7� (g)
I hereby certity the above is Irue. wrrect. and I SignaWre of Assessor � I Da;e signetl
complete.
Veritying action � SignaNre of Audimr I Date signetl
STANDARD DEDUCTION ALLOWANCE
79 _ Pay 79 _
Lesser of U2 Homestead '
Valuation or 52.000 �
Signamre of Audi;or Date signed