Homestead_Watson�• ���'�" - CLAIM FOR HOMESTEAD PROPERTY TAX
i �� CREDIT/STANDARD DEDUCTION
I� Sute Fortn 5473 (R2 / 592) �
-: , e
INSTRUCTIONS: See reverse side lor filing instiuctions.
� / / � CERTIFICATION STATEMENT
FORM YEAR
HC10
�IL��
I(VJe) L%'� D-e/L / JU N certiy that on the 1 st day March, 19
I(We) occupied as our principal pla of residence the following descnbed real property for which a Homestead P erty Tax Cr it i reby im
❑ i(We) owned ❑ Are buying under contract �ON CQUNTY AUDI70R
❑ Have a beneficial interest in the entiry thai is liable for the property ta�ces on the property and that owns the prop� r is buying under a wntract.
If buying on contracC Fee Simple owners name
Recordefs oKce where mntrect is recorded
Counry T�
/�s a n/
Parcel number LE
00�- o( 3 � -o v
If any ponion oi Ne resitlen6al structure or the 4
the O�operry utilizetl to praduce inoome.
K.�
CONTRACTRECORDED
DESCRIPTION
/ GlJ
'G .�c,lT "I �ot- [ v �
acre ihat immetliatey surtounds thai swcture is used to
PROPERTY OWNED BY CLAIMANT IN OTHER
Fereby certify the above statements are true, correct and complete.
Atltlress (number and streel, ciy, state, ZIP mdeJ
, � . �7� O
ASSESSOR USE ONLY TRUE TAX
VALUE
Land not ezceeding 1(one) acre immediately ���
surrounding resideniial improvemenis.
Otherland (2)
Total land (line 1 plus line 2) (3)
Dwelling
Residential improvements
Garage
Other improvements
Total improvements (line 4 through line 6)
Total value (line 3 plus line 7)
I hereby certi(y ihe above is true, correct, and
wmplete.
19_ Pay 19 _
Lesserot 7/2 Homestead
Valuation or 52,000
i4)
(5)
(6)
l�)
IB)
ASSESSED I HOMESTEAD
VALUE VALUE
STANDARD DEDUCTION ALLOWANCE
E9
number
Page
use
NON-RESIDENTIAL
VALUE
of Autlitor � � � I Date slgnetl 1_ O
/�1 w .( � 3