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dY:a•, CLAIM FOR HOMESTEAD PROPERTY TAX' _ . FoRM �
��"" , : CREDIT/STANDARD DEDUCTION , Hcio
� :� State Form 5473 (R2/1-90) '�°�g
�' '•�• �" INSTRUCTIONS: See reverse side (or filing instructions. �i i
CERTIFICATI STATEMENT -
`(We) __ certify tha/t,�p_n� �th�e�1 t d of M�rch , 19 �/
I(We) occupied as our principal lace of residence the follo � cribeH`f��t'(�Y �r�Rr�ch a Homestead
Property Tax Credit is hereby. claimed: I(We).owned L��J 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
property or is buying it under a contract. •
•� • CONTRACT RECORDED
If buying on contrac[. Fee Simple Owner's Name
Recorder's office where contract is recorded
PROPERTY
Couniy
Record
town,
Page : . �
. . �c.,a+�- �yw - .
Parcel Number Legal Descripti n � j ('� _� /� j C/S�� �
DO� -�o,�ooz - oa V�/ "� r �
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
l�ounty
I hereby certify t above siat
complete.
Address Str t, be . ci
ASSESSOR USE ONLY
are �true. correct and
state a
'
Land not exceeding 1(one) acre immediately
surrounding residential improvements
Oiherland
Total land - line (1) plus line (2)
Residential improvements Dwelling�
Garage
Other improvements - �
Total improvements - line (4) Ihrough line (6)
Total value - line (3) plus line (7)
I hereby certify the above is true,
correct, and complete
\/orifvinn Artinn _ Sinnnhiro nf AiuliMr
" 1989 Pay 1990
Lesser of 1/2 Homestead
Valuation or $2.500
��
of Auditor
re
TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
(' ) . . .
�
�
�
�
�
of Assesor
NON-RESIDENTIAL
VALUE
STANDARD DEDUCTION ALLOWANCE
1990 Pay 7 991 1991 Pay 1992 19 — Pay 7 9—
Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of t/2 Homestead
Valuation or $2.000 Valuation or 51,500 Valuation or 51,500
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