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Homestead_Wallacee��� g CLAIM FOR HOMESTEAD PROPERTY TAX a��;: CREDIT/STANDARD DEDUCTION �' � State Porm Sa73 (R2 / 5-92) �m• . INSTRUCT/ONS: See reverse side (or liling instiuctions. . 1 i 1 ��� � - ; ;� :�} � � � YEAR I(we) Vl.1Tt V F� )�i- �1l �,J'�3._7` A J l# 1`Il �LVI i Y` [�`"�'eeRifq-4rR e-tst-�y�March, t 9 �) occupied as our principal place of residence ihe following described real pmpeny for.�which�a HOittest��ad�Property �aii�r'eaRis ereby claimed: U I(We) owned ❑- Are buying under cnntraci - ❑ Have a beneticial interest in ihe entiry ihai is liable for the property taxes on the property and that owns the property or is buying under a contract. - - = CONTRACTRECORDED . � . ' � It b�ryirkj on contraU. Fee Simple owner's name . � ' Recorder's oflice where contract is recorded Recortl number Page Counry Parcel number � If any portion of Uu ot the properry utili � - PROPERTY DESCRIPTION ' � - ` �� � ' � SownsNp . � . S�ing tlistrict (6ty, rown, fownship). ' ' Legal tlescri ti �. . ;idential stmcture or the land not exceeding one (11 aae that immediately surrounds that stmcWre is used to produce income, describe the use arW ponion to produce income. . - � PROPERTY OWNED BV CLAIMANT IN OTHER COUNTIES " �� ' County Township Caunry Tovmship �eby certity the above statements are true, correct and complete. Signa[ure Iaimani Address (numberandsbeet, dry. slafe. ZlPCOde) � ASSESSOR USE ONLY . TRUE TAl( ASSESSED HOMESTEAD NON-RESIDENTIAL. . VALUE VALUE VAWE VALUE � Land not exceeding 7(one) acre immediately . surrounding residential improvemenis. (�) �� Oiheriand (p) � Total land (line 1 plus line 2� (3) Dwelling (4) � Resideniial improvements . Garage (g) � �. Oiher improvements (6) • Total improvements (line 4 through line � (7) Total value (line 3 pUs line 7� �g) I hereby Certify ihe above is irUe, correct, and Signature of Assessor Date signed complete. �tying aaion - Signature of Autlitor Date signed l STANDARD 19_Pay19_ lesser of 7l2 Homestead Valuation or 52,000 S Sgnature of AWitor I Date signed I