HomeMy WebLinkAboutHomestead_BlockCLAIM r R HOMESTEAD PROPERTY TAX
:4J CREDIT /STANDARD DEDUCTION
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
FORM YEAR
HC10
J
I (We) certify that on the 1st day of March , 19
occupied as our principal place of residence the following described real property for which a Homestead
P, ty Tax Credit is hereby claimed: `�e) owned ❑ Are buying under contract
❑
JHave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
property or is buying it under a contract.
CONTRACT RECORDED
If buying on contract, Fee Simple Owner's Name
Recorder's office where contract is recorded Record Number Page
PROPERTY DESCRIPTION
County Townshi Taxing trict (City, town, township)
Parcel Number Legal scrip S p A C-
- olll�`i ' (7 - 3
-a - io
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce in
-J� Z A-2-6� TILE V I
aanaFRTV nwNl =n RY CLAIMANT IN OTHER COUNTIES .IAA -. ,nnn
County
Township
County
Township
' 7y certily the above statements are true, correct and
^�le.
Signature AUDITOR
Address (Street, number, city, state and ZIP code)
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other land
Total land - line (1) plus line (2)
Residential improvements Dwelling
Garage
Other improvements _
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
1991 Pay 1992
19— Pay 19-
esser of 1/2 Homestead
(2)
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
(3)
Valuation or $1,500
Valuation or $1,500
(4)
Signature of Auditor i
(5)
(6)
(7)
(8)
hereby certify the above is true, Signature of Assesor
correct, and complete
Verifying Action - Signature of Auditor
Date Signed
Date Signed
cTANnARn nFnIICTInN ALLOWANCE
1989 Pay 1990
1990 Pay 1991
1991 Pay 1992
19— Pay 19-
esser of 1/2 Homestead
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
-:.Valuation or $2,000
Valuation or $1,500
Valuation or $1,500
Signature of Auditor i
Date Signgd 0