HomeMy WebLinkAboutHomestead_BottomsCLAIM FOR HOMESTEAD PROPERTY TAX FORM Ye�AAR
�l CREDIT /STANDARD, DEDUCTION HC10
..;; State Form 5473 (R215-92) I t
INSTRUCTIONS: See reverse side for filing instructions.
iCie) —[1( I,tiJ� —l->•— -4—I (� {xC/}y�a- certify.that on the 1 st day of March, 19y_c
I ( 'e) occupied as our p cipal place of residence the f owing described real property for which a Homestead Prop{ y�z &E7ditjq&eby claimed:
f(We)owned ❑ Are buying under contract -
/I
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the proDerty,gLis bi4g`QndlacaCOntract.
CONTRACT RECORDED
It buying on contract. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
-
PROPERTY DESCRIPTION "
County
®nty
Township
Township
Taxing district (city, town, township)
Parcel number
Legal description
true, correct and complete.
a- " - on
- I o c
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
.
surrounding residential improvements.
(1)
-
-
-
I
�i
ASSESSOR USE ONLY
TRUE TAX
PROPERTY OWNED BY CLAIMANT IN OTHE9,GPUNTIES
®nty
NON - RESIDENTIAL
Township
County -
To
I hereby certify the above statements are
true, correct and complete.
aimant
•,) re s (nu
. e 1 city. 1 .e, D
c d
.
surrounding residential improvements.
I
�i
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
.
surrounding residential improvements.
(1)
-
-
Other land
(2)
Total land (line 1 plus line 2)
(3)
,
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pUs line 7)
(6)
ti =reby certify the above is true, correct. and Signature of Assessor
00 plate.
Date signed
verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 —Pay 19_
Lesser of 1/2 Homestead
$