HomeMy WebLinkAboutHomestead_Firkinsrtxn t CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R215 -92)
INSTRUCTIONS: See reverse side for filing instructions.
- -- "'=• CERTI CATION STATEMENT"
I (We) certifyttaflonae��5t�d oyy�f Mja 19_
_ I-(We) occupied as our prin I place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed
rf I (We) owned ❑ Are buying under contract MAR 0 9 1999
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns thQ.property or is buying under a contract.
CONTRACT RECORDED.-
If buying on contract. Fee Simple owner's name
Recorder's office where contract is recorded
FORM YEAR
HC10
Record number I Page
PROPERTY DESCRIPTION.
Co ty Township Taxing distr 6GIty, town, to-ship) -
Parcel number V Legal description IF
DD �3 �D -11) 5
It any portion of the residential structure or the land not exceeding one (1) acre that ifnmediately, surrounds that structure is used to produce income. describe the use and portion
of the property utilized to produce income.
- / -3- 30 - 1Q() -Oa 0.63 406 S
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES, .
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signatur almant
VALUE
VALUE
�dre (nu Creel, dry. state, ZI e) '
1
``
TRUETAX
ASSESSED
HOMESTEAD
NON-RESIDENTIAL ,'
ASSESSOR USE ONLY
VALUE
VALUE
VALUE
- VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Otherland
(2)"
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
-
Residential improvements
Garage
(b)
Other improvements
(6)
-
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plis line
(g)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
-
STANDARD DEDUCTION ALLOWANCE':
19_ Pay 19_
Lesser of 112 Homestead
S
Valuation or $2,000
gna re of A oil
Date sig — —^