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i�^�, CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
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s�� CREDIT/STANDARD DEDUCTION Hcio �
•`.?1�y,�,i,.•� Stale Form 5473 (R2/1-90)
'"" INSTRUCTIONS: See, reverse side lar liling instruc(ions.
CERTIFICATION STATEMENT �Q �� ,��
, � � �.:. .,. .._�
I(We) certify that on the 1st day��q�vl�rCh��d�
I(We) occupied as ur principal place of residence the following described real property (or wl�ich a Homestead
i
i operty Tax Credit is hereby claimed: I(We) owned ❑ Ate�uyirUg���iract
H U
� Have a beneficial interest in the entily that is liable for the property taxes on the property and that owns ihe
property or is buying it under a contract.
on contract,
contract
CONTRACT RECORDED
PROPERTY DESCRIPTION
Description
Taxing Districl (Cily
Page
_.�_�a 9.s1
If any portion of the residential structure or the land not exceeding one (1) acre thal immediately surrounds that struc-
iure is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding 1(one) acre immediately
surroundingresidentialimprovemenis (�)
Olherland (2)
Tolal land - line (1) plus line (2) (3)
Residential improvemenls Dwelling (4)
Garage (5)
Olher improvements (6)
Tolai improvemenls - line (4) ihrough line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify lhe above is true, Signature of Assesor Date Signed
correci, and complete
Verifying Aclion - Signature ot Auditor Dale Signed
1989 Pay 1990
sser of 1/2 Homestead
Valuation or $2,500
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991
Lesser ol 1/2 Homeslead
Valualion or $2,000
�
1991 Pay 1992 19 — Pay 19 —
Lesser ol 1/2 Homeslead Lesser of t/2 Homestead
Valuation or $1,500 Valuation or $1,500
Signa[ure of Auditor n ,� I Date Signed