HomeMy WebLinkAboutHomestead_Naas (10)a� "�' i CLAIM FOR HOMESTEAD PROPERTY TAX "
i��;: CREDIT/STANDARD DEDUCTION
� State Form 5473 (R2 / 5-92)
,�i'
INSTRUCTIONS: See reverse side !or /iling insbuctions.
� � �" ' � CERTIFICATION STATEMENT . - ' -
FORM
HC10
YEAR
I(We) • Q CL � � d—� certity ttm�ep1pnN1�1e7s[�f March, 19
�e) occupled as our principal place of residence the foliowing described al prope r which a Homestead PIdpE�rtyTau Credit is hereby Gaimed: .
I(We) owned ❑ Are buying under contract
I❑ Have a beneficiai interest in the entiry thai is liable,for the property taxes on the property and that own�iie pro��j;l�ifi,g �,_� ntract. _
� � - � � - � - .CONTRACT RECORDED -� ' � � � � �
If buying on contrac;, Fee Simple owner's name � ' ' , �
Rewrder's oHice where contract is recortled RecorU number Page
It any
of the
4
1 . - - - � � PROPERTY DESCRIPTION ' �
� � Township � ^�j Taxing disvia (ciry. own, wnship) - �/� �
� � • _ • . .� �i"dl�f �
�r legal description
/ -DO _ .
o� Ne reSMential StmcWre or Ihe Idfld no� etCeCtliflJ one (i) aCfe Nal immetliately 5urrounds lhalSWCNre i5 u5ed to prOdufR inCOme. deSCnb¢ �he u5e a0d portion
y u6lized m produce income. _
. . r.
�'G-a3 /%/�D- ��/, ��� �a�
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES �
Township Couniy Township
cenify �e�nis arg irue,
ciry.
ASSESSOR USE ONLY
Land not exceeding t(one) acre immediately
surrounding residential improvements.
Otherland
Total land (line 7 plus line Z�
Dwelling
Residential improvements
Garage
Other improvemenis
Total improvements (line 4 through line �
Total value (lirte 3 p�s line 7� -
I hereby cenify Ihe above is true. correci, and
�mplete.
Venrying action - Signature of Audiror
79_Pay19_
Lesser of 1/2 Homestead
1 v�Wation or 52.000
Auditor
TRUE TAl(
VALUE
(�)
l2)
(3)
(4)
(5)
(6)
(�)
(8)
STANDARD
3
ASSESSED
VALUE
ALLOWANCE
HOMESTEAD
VALUE
NON-RESIDENTIAL. ^
VALUE
Date signed
Date signed