HomeMy WebLinkAboutHomestead_Sumner�'`°;, CLAIM FOR HOMESTEAD PROPERTY TAX Y AR
FORM
' CREDIT/STANDARD DEDUCTION HC�o �
:�� State Form 5473 (R2I S92) 0�
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INSTRUCTIONS: See reverse side for fi/ing instructions_ ..
CERTIFIC ON STATEMENT
I(We) Q � G�CeMf�'lh2i'ohThe 7 st day of March, 19_
I(We) occupied as our principal place of residence the following descnbed real property for which omestead Prop� Tax C edit hereby claimed:
i
❑ I(VJe) owned ❑ Are buying under contract - `�;�?�
❑ Have a beneficial interest in the entiry thai is liable for the property taxes on the property an a(}Fgg6`�Ff�p�rt��d`�iuQing under a coniract.
' CONTRACTRECORDED �
_ If buying on contract Fee Simple ownefs name
Recortler s olfice where convact is recortled ' - Fiecord number - Page
PROPERTY DESCRIPTION
Counry Township Tauing si' (dqt town, rownship
Parcel number Legal desc ptio
' �b� �� —.�-l�S , o ��
I any porGOn of Ne residen6al sirucNre or ihe lantl not ex eeding one (1) acre ihat immediatety surtountls Nac structure is used lo produce income, descnbe the use and portion of
the Droperry utilized to produce income.
07�- 9 Oo1- Go - O�� �e o� O�S
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Counry Tovmship
SiqnaWre oi claiman[
�ereby certify the above statements are true, correct and complete.
Address (number and streeL ciry, state, ZIP cade)
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTAI
VALUE VALUE VALUE VALUE
Land not ezceeding 1(one) acre immediately � (��
surtounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) (3) �
Dwelling (4)
Residential improvemenis
Garage (5)
Other improvements (6)
Total improvements (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is Irue, correct, and Signature of Assesor Date signed
complete.
Verifying action - Signature of Audimr Da[e signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead - S
Valuation or 52,000
Sgnawre oi AuOitor Date signed