Homestead_Wernke.��°•*• CLAIM FOR HOMESTEAD PROPERTY.TAX ,
d��` ° _
-, --y : CREDIT/STANDARD DEDUCTION � - '
� ' State Form 5473 (R2/1-90) " �
,' '°�• � INSTRUCTIONS: See reverse side (or liling instructions.
, ,
CERTIFICATION STA
FORM
HC10
I(We) W(J� Y• af- � i�p�,' �� w� the tst day of March , 19 9C7
t'We) occupied as our principal place of residence t,�he, �following described real property for which a Homestead
Property Tax Credit is hereby claimed: :' !�" I(�Ne) owned ❑� AYe buying under contract
, �
� Have a beneficial.interest in,the entity that is liable for the property taxes on the property and that owns the
_ property or is buying it under a contract. •
CONTRACT RECORDED
on contracl. Fee Simple Owner's Name
's office where contract is recorded
PROPERTY
County
Record Number � Page
RIPTION �(9-o�o4i-ao
rarcei Numtier �ega npu y �
n�-t� -�za o9 i� rzr� - c� y� c�'y � �- a- lo - o�� C -
Ii any portion of the residential structure or the land not exceeding one (7 ) acre that immediately surrounds that struc-
ture is used to,produce income describe the use and portion of fhe property utilized to produce income.
County
..-�..-
PROPERTY
BY CLAIMANT IN
certify the above statements are irue. correct and
Address
state and ZIP code)
ER�COUNTIES
- � ASSESSOR USE ONLY � �� �� TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
NON-RESIDENTIAL
VALUE
Land not ezceeding 1(one) acre immediately _
surrounding resideniial improvements (� 1
Oiherland (2)
Total land - line (1) plus line (2) (3)
� Residential improvements Dwelling _ . (4)
Garage (5)
Oiher improvements (6)
Total improvements - line (4) ihrough line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
1989 Pay 7990
Lesser of 1/2 Homestead
Valuation or $2,500
STANDARD DEDUCTION AL
1990 Pay 1991 1991 Pay 19
Lesser of 1/2 Homestead Lesser of 1/2 Horr
Valuation or 52.000 Valuation or $7
! Pay 19—
1/2 Homestead
�n or $1,500
of Auditor / � � �-1/� �j�+ )� Si�e� _ cQ
� /n/1.sL �� I Lld n n. AUDITOR �