Homestead_White (6)-'�-` CLAIM FOR FIOMESTEAD PROPERTY TAX
,..•,....4
Cd'�_F
,� � � CREDIT/STANDARD DEDUCTION
��� Stale Form 5473 (f12/t-90)
'"" 1NSTRUCTIONS: See reverse side !or liling insiruclions.
ATEMENT
FORM AR
IIC10
^ I �(�n/e) � I�41� 0.(�(� �_ cerlily thal on the I st day ol March , 19 �d
I(We) occupied as our prin�ci�pal p(l�c�e I r si e c Ilie followiny described real property for whicli a Flomestead
(� Properly Tax Credit is here6y cFa'tt'Sie� �� ��❑ I(We) owned ❑%1re buying under conlracl
� 1 fave a beneficial inlerest in Ihe enlily Ihal is liable (or Ihe properly laxes on Ihe�ro�er�ly ai�ha�l owns ihe
property or is buying il under a conlracl. ��
II buying on conlracl, Pee Simple Owner's
Couniy
where coniracl is recou
� , Township
CONTRACT RECORDED
me
PROPERTYDESCR
Legal Descriplion
. v
II any poilion of Ihe residenlial slruclure or Ihe land nol exceedi g one (1
Wre is used lo produce income describe Ihe use and poiiion ol lhe prope
,re Ihal iriimedialely surrounds Ihat slruo-
utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTfiER COUNTIES
ASSESSOR USE ONLY
Tf7UE TAX VALUE
r+ot+-nesioe�+nn�
VALUE
Land nol exceeding 1(one) acre immedialely
surrounding residenlial improvemeids ( � )
Olher land (2)
Tolal land - line (1) plus line (2) (3)
flesidenlial improventenis Dwelling (4)
Garage (5)
Olher improvemenls (6)
Tolal improvemenls - line (A) Ihrough line (6) (i )
Tolal value - line (3) plus line (7) (8)
I tiereby cerlily Ihe above is true, Signalure ol Assesor Dale Signed
correcl, and complete
Verilying Aclion - SignaWre ol Audilor �ale Signed
1989 Pay 1990
lesser ot tl2 Flomestead
Valualion or $2,500
Gfl
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 1991 Pay 1992 19—Pay 19_
Lesser ol t/2 I lorneslead Lesser ol t/2 Flomeslead Lesser ol i/2 Flomeslead
Valualion or $2,000 Valualion or $1,500 Valualion or $1,500
Dale S,i9J'e
`"J ' / '