Homestead_Watt (9)aE —'"� � CLAIM FOR HOMESTEAD PROPERTY TAX ��
� �� CREDIT/STANDARD DEDUCTION
` !�. State Form 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side for tiling instructions.
FORM
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[�Y 101994
YEAR
�,r., -,�., ,v . .. .o
) Q./vv�n4a �✓ certify tt�t��� y of March, 79
I �.ae) occupi s our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby Gaimed:
�I �We) owned �Are buying under contract . ,�
Have a beneficial interest in ihe entity ihat is liable for ihe property taxes on the property and ihat owns the property or is buying under a contract.
If buying.�_.__". _—_ -Sple nw,.e:...._.___ - . - � —_ . �
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Recortler's�n�c��..����,.,,.�.:act�...,.,..,.�.. � � , ..
- PROPERTY DESCRIPTION
Township Taxing dist � (CU . fown,
Record number
6
Page
I number Leg�� escription
)lo-O'J1�1 jC' W 51�.� 3- a-IU �6.UUu.�
ponion of ihe residentiai strucwre or Ne lantl not ecceeding one (7) aae ihat immediately wrrounds ihat swcture is used to produce income, descnbe ihe use arW portion
pmperty utilizetl m produce income.
PROPERTY OWNED BV CLAIMANT IN OTHER COUNTIES
Counry Township COUnty . TownShip
�eby certify the above statements are true, wrrect and complete. Sig wre laimam
Address (number a�streeC dry. sla7e, ZlPcotle) -
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON•RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvements. (�)
Oiher land (p) �
Total land (line 7 plus line Z� (3)
Dwelling (4)
Residential improvements
Garage (g�
Oiher improvements (6)
Total improvemenis (line 4 through line b] (7)
Total value (line 3 p�s line � (g)
1 hereby certify ihe above is lme, corrett, and Signawre of Assessor Date signed
r�mplete.
�irg aaion - Sgnamre ol Auditor Dare signed
79_Pay19_
Lesser of 1/2 Homestead
valuation or S2.000
S
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