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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
; State Form 5473 (R2 15.921
INSTRUCTIONS: See reverse side for filing instructions.
occupied as our principal place of r si ence the
l lnE(. QC fI_ certify
real property for which a Homestead
LI 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
CONTRACT RECORDED
It buying on contract. Fee Simple owner's name
Recorder's price where contract is recorded
FORM YEAR
HC10 7c5-
o h ls, ar .19
erty ax redit is hereby claimed:
(x-11 1995
.riv or is buvina under a contract.
Record number I Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION
County
Township
County
Taxing district (city. fawn. township)
Parcel number
O —00
Legal description
—
h any portion of the residential structure or the land not exceeding one (1) acre that immediately surrountls that structure is used to produce income. describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
TRUETAX
Co
County
Township
County
Township
\
certify the above statements are true. correct and complete.
- )
nature cl mam
Oco
Address (number and street city. 5fafe. ZIPCOde)
Y / , / l 3. Aer/-
7 7
ASSESSOR USE ONLY
TRUETAX
ASSESSED
HOMESTEAD
NON-RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
_ _
surrounding residential improvements.
(t)
Other land
(2)
Total land (line I plus line Z)
(3)
ling
(a)
Residential improvements
rGa
ge
( 5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3plrs line 7)
j6)
I hereby certify the above is true. correct. and
Signature of Assessor
(Date signed
complete.
1 V, ifying action Signature of Auditor
A,
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
S
Valuation or $2.000
Signature of Audit
Dat igned
_ _
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 IRS / 10-01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
,(we)
WI (We) upied as our principal place of residence the following described real property
�,Zwo'l owned ❑ Are buying under contract
a beneficial interest in the entity that is liable for the property taxes on the property
FORM YEAR
HC10
U K tlPonZUZt day of March, 20
astead ProoertvTax Credit is herebv claimed:
a contract.
A
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
OPIERTYDESCRfRTION
County
County Township
I /
Township
Taxing district y own, township)
Parcel number
Legal d
Is the property in ques kon:
711V k1-y
7's
❑ Real property ❑ Mobile Home (LC. &-1. 1-7)
Ilia n 1 8 iden u
c thel 'dno exceeding one (1) erne that immediately surrounds that structure is used to produce income, descnbe the use and Portion
,ff�orho2j
or Aproper!p�llae
ntge
e.
Mt
surrounding residential improvements.
L' I
County Ta nship
I
County Township
I /
I hereby certify the above statements are true, correct and complete.
Signatu)(% clal
U�
ess (number and street, city, state, ZIP code) I
L' I
20 _ Pay 20_
Lesser of 112 Homestead
Valuation or $6,000
Date signed
K-TMRVALIEL6:TEA' X
AASSESSOWU
SSESSYE D-VALUE
VHOVMAELSUTEE0AW.�
�.F e5
SE ON LX .
A, � . . . . .
UWTE
�A -A
QM
`NON
P
.
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)
--Mi
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
(a value (fine 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20_
Lesser of 112 Homestead
Valuation or $6,000
Date signed