Homestead_Theys��
.•^�. CLAIM FOR HOMESTEAD PROPERTY TAX
e�"� °,
;;�-y ; CREDIT/STANDARD DEDUCTION .
� ;� State Form 5473 (R2/1-90) �
�' '°�• � INSTRUCTIONS: See reverse side for liling instructions.
CERTIFICATION STATEMENT
2
YEAR '
i
AUG 27 19°1
–} (,��� �'. in,��Cr.s
i(We) ��4�A�.���u� �Q r}- �(� �� I��� certify that on the 1 st d�1�3D�1�h , 19�
�(We) occupied as`e'�f principal place of residence t,�he, f�ollowing described real property for which a Homestead
Property Tax Credit is hereby claimed: LJ' I(We) owned ❑ 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 contract. Fee Simple Owner's Name -
Recorder's office where contract is recorded Record Number ' Page
PROFERTY DESCRIPTION
County
Parcel Number
town,
liany portion of ihe resideniial structure or the land not exceeding one ( 7) ac�e 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
County Township County � , . Township
. hereby certify the above siatemenis are true. correct and �Signature �
complete. ' � �
Address (Street, number. city, state and ZIP code)
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-qESIDENTIAL
VALUE
Land not exceeding 1(one) acre immediately �'' �
surrounding residential improvemenis (�)
Oiherland (2)
Total land - line (7 ) plus line (2) (3)
Residential improvements - Dwelling (4)� - � - � �
Garage (5)
Other improvements (6)
Total improvemenis - line (4) through line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true. Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
1989 Pay 1990
sser of t/2 Homestead
Valuation or $2,500
Signature of
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 � 1991 Pay 1992 19 — Pay 19 —
Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or $2.000 Valuation or $1.500 Valuation or �7,500
Date Signed