Homestead_Vickers�..�++.
ei ' i CLAIM FOR HOMESTEAD PROPERTY TAX
�%�= CREDIT/STANDARD DEDUCTION
� State Form 5473 (R2 / 5-92)
�
INSTRUCTIONS: See reverse side 7a /iling instructions.
FORM YEAR
' 1
�
•!�r 2 7 1997
I,(W�_��� _ T ' V t/ rtify that-�ihe �}�fj l�r�/, 19_
,.�/� �-1
�) occupied as our princi al.place o sidence ihe following described real property for which a Ho t�� ��T��[I�Tf�F�b� claimed:
IJ I(We) owned ❑ Are buying under contract
❑ Have a beneficial interest in ihe entiry that is liable for the property taxes on the pmperty and that owns the property or is buying under a contract.
. CONTRACT RECORDED . - - . .
If buying on contract, Fee Simple owner's name - .
Retorder's oHite where contract is recorded ReCOrd number Page
Jl0 _
ponion of
pmpeny i
PROPERTY
Legal
idential strucwre or the land not exce§tling one (11 a�e thai irtlmediatey surrountls Nat structure is usetl to produce irrume, tles�ibe ihe use and ponion
ro protluce income.
r. _ ,.
PROPERTY OWNED BV CLAIMANT IN OTNER COUNTIES '
TownShip Caunry Township
cenify the above statements are tme, correct and complete. I'9^ �`\e of claimant ` �
Address (numberandsfreet, dry, state. ZlPmde)
� y
ASSESSOR USE ONLY THUE TAX ASSESSED HOMESTEAD NON-RESIDENitAL
VALUE VALUE VALUE VALUE �
Land nm exceeding 1(one) acre immediately
surroundin9 residential improvements. (�)
Otherland (p) ��
I
Total land (line 1 plus line Z� (3)
Dwellinq (a) �
Aesidential improvements
Garage (5)
Oiher improvements (6)
Total improvements (line 4 through line � (7) I
Total value (line 3 p�s line � (e)
I hereby tehify Ihe above is true, torreCi, and Signa;ure of Assessor ' I Date signed
mmplete.
Veritying acUOn - Si9namre of Audibr . Date signed
�
STANDARD DEDUCTION ALLOWANCE
19_Pay19_
Lesser of V2 Homestead
Valuation or 52.000 S
S' aNre ol uditor Date si tl� �