Homestead_Turpina rt�� t CLAIM FOR HOMESTEAD PROPERTY TAX
i� '�� CREDITISTANDARD DEDUCTION
j State Form 5173 (R2 / 5-92)
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INSTRUCTIONS: See reverse side !or /iling instructions.
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FORM YEAR
HC10 \
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I(We) � _ ��J d�J � 2/la CLUIClJ! 1`'� ce�r ity that on the 1 s�day of March� 19_
�� Ye) occupied as our p ncipal place of residence the followin9 described al property tor which a Homestead P o` rty�Tex Credibis-hereby claimed:
�,-�. � In�-'�l-, !
(We) owned ❑ Are buying under contract G{F`�� ��� �
❑ Have a beneficial interest in the eniity that is liable for ihe property taxes on the property and ihat owns the property or is buying under a coniraci.
- , ._ : . . �_: - . �.:- - .CONTRACT�RECORDED-�.: � ..-. .., • .. . ;.. .: , .:. -> �.. :� � = � - .:s:.:..� -.
It buying on contract, Fee Simpie owner's name
Recortler's oHice where conirac[ is recortled RecorO number Page
Counry
� "° �- " PROPERTYDESCPIPTION - -a"°,-�>
Township Ta�cifg distritt (dty. fown. township)
Parcel number Legal d tion
�Q-�,�3. � �p� x C� � y-,� - �� /. �� �� �
If any ponion of Ne residential structure or the land not exceeding one (1) acre tha[ imme0iatety surrounds that structure is used ro produw inmme,
of ihe D�operry utilized to protluce inmme.
Ne use and portion
� � PROPERTV OWNED BY CLAIMAHT IN OTHER COUNT7ES �
Counry Township Counry 7ownship
reby certify the above statements are true, correct and complete. Si wre of ciaimam
Address (number and sfreeC ary, sfate, ZIP code) '
. � ASSESSOR USE ONLY TRUE TAX 'ASSESSED NOMESTEAD � NON-RESIDENTIAL`, -�
�� � VALUE VALUE VALUE VAIUE �.
Land not exceeding 7(one) acre immediately � =.� �
surrounding residential improvements (�� � � ��`��
Otherland (p� ,�J.a"�.��. ��'
Total land (line 1 plus line 2� (3�
Dwelling (a) �� . � � - _ . � � �
Residential improvements .
Garege (5) � -
Other improvements (6) �
Total improvements (line 4 th�ough line � (7)
Total value (line 3 p6s line � (g�
1 hereby certify the above is Irue, correGt, and Synature oi Assessor Dare signed
complete.
�tyirg action - Signature of AuGitor Date signetl