HomeMy WebLinkAboutHomestead_Collins (5)a`�°a
,� CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
r CREDIT/STANDARD DEDUCTION HCio
` SWte form 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side �w filing instructions. `; :r ..
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I(We) \ ` � certify�that orTth�l� d�; i
I(We) occupied as our principal place of residence the following described re property for which a Homestead Property Tax Cr�
�I(We) owned ❑ Are buying under contract � _� .'--��-'.� r ��
�Have a beneficial inierest in the entity that is liable for the property taxes on the property and that owns ihe property or s bvy.�ng i
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If buying on coniratt, Fee Simple owner'S name�
Recorder's ottice where comract is recorded
County TownShip �
P rcel number Leqal descrip on
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If any portion of the resitlential structure or ihe land not ezceeding one (7
of the property utilized to produce income.
Record number
19
claimed:
Page
surmunds ihal structuie IS9�ed to produce income, describe the use and portion
�t5'.ASSESSORUSEONLY `� - � �� � TRUE�TAJ( - ����=ASSESSED � �� HOMESTEAD� � � � NON-RESIDENTIAL' ��
� � VALUE . � VAGUE. . VALUE �� .- � ` VALUE = '
Land not exceeding 1(one) acre immediately �- ' �
surrounding residential improvements. (�� - � `�� ' �
ra �
Other land - (p) � t � ¢ � '
Total land Qine 7 plus line 2� (3)
,...._. .,_a. .,.,-, �,-
Dwelling (a) � � - . ' � � '
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Residential improvements . _ _ _, -
Garage (5) . . -_ _ . ° `
Other improvements (6) � �� . - � �
Total improvements (line a through line � (7)
Total value (line 3 p�s line � (g) I
I hereby Certify the above is Irue, Correct, and Signature ot Assessor Date signed
complete.
Ventyirg action - Signature of Auditor . Date syned
. . . � . ��,:gl �
�� 19_Pay19_
Lesser of 1/2 Homesiead
Valuation or 52,000
Signature of Autlitor
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