Homestead_Truelock�.^.�
e� = � CLAIM FOR HOMESTEAD PROPERTY TAX
a,•�'� CREDIT/STANDARD DEDUCTION
�,,,�� State Portn Sn73 (R2 / 5-92)
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INSTRUCTIONS: See reverse side lor liling instruc(ions.
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��We) _�,J (/Y�,(2 _X,�' [� -�f CX/ l.l,O�.��JI,Q� �`{ �! 1(J JLl���ify that on the 7 st day of March, 79
.e) occupied as our principal place of residence the following described real-property for which a Homestead Property Tax Credit is hereby claimed:
❑ I (We) owned ❑ Are buying under contracL . . . . . - -
❑ Have a beneficial interesi in the entity that is liable for ihe property taxes on the property and thai owns the property or is buying under a contraci.
� ; CONTRACTRECORDED� - . � •
It Duying on contracL Fee Simple owner's name � . ,. • � - . . . , . .
Recorders otfice where contract is recorded qecortl number Page
PROPERTY DESCRIPTION
Counry � . Townsttip . - Ta�cing tlistrict (ciry, town, township) - _ - f " •
p�.cel numher Legal tlescription
b-oraq?-oo -a= o .6 `���
If any portion oi ihe residential strucwre or Ihe land not exceeding one (1) acre that immediatety surrounds �hat strucmre is usetl to produce income, describe ihe use and ponion
of the propeny utilized to produce income.
_ . . . . ._ . .. . .t�' ' _
PROPERTV OWNED BY CLAIMANT IN OTHER COUN'fIES �
Counry Township Counry Township
�reby certify ihe above statemenis are true, correci and complete. Signawr Ca;man2 � �
Adtlress (number and sireei, dty, state. ZIP code) �� # ��
ASSESSOR USE ONLY TRUE TAX � ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE . VALUE �
Land not exceeding 1(one) acre immediately � - �
surrounding residential improvements. I (�) �
Otherland � (p) �
Total iand (line 7 plus line 2� �3) .
Dwelling (4) - �
Resideniial impmvemenis _ .
Garage . (5) ..
Other improvemenis -. (6)
Total improvements (line 4 through lina � (7)
To�al value (line 3 p�s line � (g) • "
I hereby certify the above is Irue, correct, and .Signature of Assessor Date signed
complete.
'��tying action - Sgnature ot Audimr � Da:e signed
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19_Pay19_
Lesser ot 1/2 Homestead
Valuation or 52,000
STANDARD DEDUCTION ALLOWANCE
S
ate signetl
�-ag-