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HomeMy WebLinkAboutHomestead_BolinCLAIM FOR HOMESTEAD PROPERTY TAX YEAR CREDIT /STANDARD DEDUCTION lkijpj . State Form 5473 (19215 -92) INSTRUCTIONS: See reverse side for Tiling instructions. FEB 1 7 1993 i /� .. eAI In11'� n/��� .S I (We) IAMM+.A, 1 certify that on thAl4(etUyTdr/mH h, % 93 I (We) occupiedU our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed, I (We) owned ❑ Are buying under contract Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract- CONTRACT RECORDED It buying on contract, Fee Simple owner's name . Recorder's office where contract is recorded Record number Page " PROPERTY DESCRIPTION County Townsh Taxing district (city, town, township) Parcel number Legal descrip ion a of claimant If 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. o PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County Township County Township I hereby certify the above statements are true, correct and complete. a of claimant s ber d street dt state, ZIP code) 7 I/ ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL.' •. VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements. (1) Valuation or S2,000 _ Otherland (2) i7 Total land (line 1 plus line 2) (3) Residential improvements Dwelling (4) Garage (5) Other improvements (6) Total improvements (line 4 through line 6) (7) Total value (line 3 plus line 7) (6) 1 hereby certify the above is true, correct, and complete. Signature of Assessor Date signed Verifying action - Signature of Auditor Date signed STANDARD DEDUCTION ALLOWANCE 19_Pay 19_ Lesser of 1l2 Homestead S Valuation or S2,000 Signature of Auditor Date signed 3 i7