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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION '
Sta�e Porm 5473 (R2 / 5-92)
INSTRUCTIONS: See reverse side for liling inst�uctions.
FORM YEAR
l C��'� $
u �_ �� .�
I�we) � +a �.tM.� $4S.�1Qt11 +' ��yw�XL.7l Ptlh�iG�V"� certify that orj�fbe�ist,day of March.�79e7��
1�� �r7 n--
�) ocqlpied as our princip � c residence t�e following descn e re91 p�pperty tor which a Homestead Property Tax C��J �herreoy.claimed:
1
[A_I I(We) owned ❑ Are buying under con�ract (� ` 1�
1- 1 \
�_! Have e beneficial interest in the entity Ihat is liable for the properiy taxes on the propedy and that owns the property or is buying under a crontract.
CONTRACTRECORDED
If buying on contracL Fee Simple owner's name
Recorder's oKice where contract is recortled Recortl number Page
County
Parcel number
PROPERTY
lown.
'W A�l�.� �j'�-10 3.12 RC
If any portion of the residential stmcture or the land not eKceading one (l l acre Ihat immetl�ately surmuntls that simaure is usetl to protluce income. tlescribe Ne use and portion
af the pmperty milized ;o protluce income.
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not e.ceeding 7(one) acre immediately I' � I I I
surrounding residential improvements.
Otherland (p) (
Total lantl (line ] plus line � (3) I I
Dwelling (a)
Residential improvements
Garage I�S) I I I
O�her improvements (6) I
Total improvemenis (line a through line b� (7) I I
Total value (line 3 p�s line 7� (g)
I hereby certity the above is Vue. CorreC�. and Signamre ot Asseswr IDate signetl
complete.
V�er�lying anion - Sfgnawre oi Autliror I Date signetl
STANDARD DEDUCTION
79_Pay79_
Lesser of 1/2 Homestead
Valuation or 52.000
Signawre of Autliwr / � �`� • � �",/ � I Da� �g=ed _ � �
( �� � W