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HomeMy WebLinkAboutHomestead_Ziliak (5)� �. CLAIM FOR HOMESTEAD PROPERTY TAX - CREDIT/STANDJ�¢.RD,DEDUCTION ' StateFOrm5�?73{RP!��72;Z_�-='_ .. .' 2 ' _ . ' . .. �%' ' i. INSTRUCTIONS:.Seereversesidelw�/r�ag�{nstr"uiYibns.`>���;�•r'..�i<=�;�:;�_; ; • = e .. iiiiC 9 � � CERTIFICATION STATEMENT..: ,_ " " � "° " ' � . I (We) _ :'� � ..:: . . ' . ..:; . ° �.�cl - ._,L�� cerLfy�that�t�ayot t�lpwy �� [ . '"" ��oied as our principal plece o[ r siderice i.tie foliowing�describ eal property for which a Homestead Property Taz���ji�sTQ��ab claimed .�� � � _ ;) owned ❑ �Are buying under contract . � � � - ' . � - � � �' �i.: I❑ Have a beneficial interestirilheentity thai i9lidb�e.for 1he pmperty�taxes on the property and that owns iFie property or is buying under a contract. . :r•. � i�. - . � - '- � � "'.��CONTRACTRECORDED It buying on contract. Pee Simpie owner's name � � - " . " `� - . . �.. i �;.. . . . ' . .:. . _. .__.. ., . . Recorder's ottice where contrect is recorded . � - _ pecortl number . Page � �- ' _ `, .. . . . . � . - _ _ . - � _ _ ' ' � � - --� PRnPERTX DESCRIPTION � : � � ' � . I Counry _ Townshi � � s Tasinq QS7nEt (City fown townshrp) �� _ . � .� Parcel m . ber ' legal descripnon. - � � � ' - . . . �oo�-oloQa-o (�' �. .a5 3- I - � lI� . . If any portion o( the resitlential strucmre or Itk IaM not exceedinq one (7) acre Ihat immediately surtounds that strucNre is used to protluce income. describe lhe use arM portiom ot the propeny utilized to produce irimme. ' _ � � � . . . . . . _ - . - . • - r. . � . - - _ -- .. . ' " , . .. '_.` i • _ ' , . . . : " _ . _ . ' . ' � . +. i:. PROP.ERTY OWNED BY CLAIMANT IN OTMER COUNTIES � Counry . �'_' Township';°.,;"� � . Cauniy � TownsNp II hereby cenify the above statements are true, correct and complete. Sig wre� ciaiman2 - � g1���mberandslreel,dry.sfa(e.ZIProUe) _ � � / -_ ASSESSOR USE ONLV � TRUE TAX ASSESSED HOMESTEAD .-NON-RESIDENTIAC - . �,�VALUE VALUE. , VAWE _ � . ;iVpLUE.r,- � r Land not exceeding 7 (one) acre immediately -: .. ( � � �;, , �: �, . • �. - . . ' surrounding residential improJements: � . =_ i ` ��` � � I "�" � ,_., -_ : ........_- --. _. � Otherland .� � � (p) . _ _ -- - ,- _ ,- - - '� i�. ! . . ' _ r -;,;... � .. . . _ _ _ - _ Total lantl (line 1 plus line Z� � : � .(3)-.. . - ,�.. �, , . . - ti�� ... __.. ., . � Dwe0m9�' � �f4) � � . . .. . -- � � � .. ' . .. . - . _ - - - Residential impmvements . - = _- � = - _ - _- - -.���!_' . - � Garage � .. . ;) . .: : :,;._•: :':' -. : _ - 1SJ:.: _ . A _ ._ .. - .... :..:: . .. - Oiher improvemenis � ' � ' - ,(6) � � - � _ - . - � ' �- .. , . . . . . .. _ �.. - , iotal improvements (line 4'through line bj � -� � �7) . � � " - . - � - % - � p. � ' _ Total value (line 3pbs line � ' . � . _ .. �� (8) � , . ,- � .:' r:: ` . -- ' .-r:c :,i� I hereby certify the above i5-hue,;correCi.-and��:••a- : ��= Signamre of Assessor,. � . _�.-; :, _ _ . � .-;.,,_ ;; ..-.: �; � C �ate signed�. � - . � - -_...- .. . , . - .': - :� �` _ .. 's . ... .' t��. complete. , ., ' Veritying action - Signature of Auditor �-� - _ i�. � i' : Dase sigaed-", �, . . .-_ ��. � , : .' . - . • . . r ' r�- ��- ,,,( :�x. - . � . ' i �-:�� { ��-. ✓ U� - > _ - .. ` :..� STAN6AF�D DEDUCi . N�AIL•OW '�� CE } - y _.,...:�;rt, , . . � 19 � , �Pa� 79 � . . ' _ . .. _ - ���' ��::�r• � ��� .. � . .. esserof�l/2HOmestead...- : ; - - .-�� �,.�=� - � . .. � :: . .,. .� _ � .:: - - = _ - � .. . � -�._ - . .. �., i. . . _. � . . � Valua r 52.000 " � . � - . - � � Sgnature of Audimr ' � - . .. " ' _ ' ' ' . � ' Date s' etl ,4:; - - - - - 2 �3