Homestead_Wildt (6)�a vd�
ad "` i CLAIM FOR HOMESTEAD PROPERTY TAX
;>�� CREDIT/STANDARD DEDUCTION
�;; � State Form 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side /or filing instructions. .
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DEC p 8 1997
I(We) �(y'►,�y��9.� - i1J Y_ N��(�.I�.L Y _ cenify that on}ingJ�t �a7oVCd�[qii 9�
�) occupied a� ;ur principal place of residence the following described real property for whicb a Homestead Property T37F'CtEtlit�3lh'ef�by'ci�Bfl�d
(We) owned _❑ Are buying under contract - , ,
❑ Have a beneticial inierest in the entiry thai is liable for the pmperty taxes on ihe property and that owns the property or is buying under a contract.
� CONTRACTRECORDED' - � � � � �
It Wying on contract, Pee Simple owner's name . ' .
Recortler's o,Hice where contract is recorded Record number Page
Caunry
TownShip
DESCRIPTION
T�ing district (city, rown.
Parcel number Legal tlescription
m�ob -�0353 Q-� n,)�.. jv-�- I� �-1D �•59?F� 1
It any portion of ihe residential stmcture or Ne land not exceeding one (1) aae ihat immediately surmunds that structure is used to produce i�ome, describe Ihe use and
ot the properry utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES - �
Caunty 7ownship County Township
�eby certify ihe above statements are [rue, correct and complete. Signamre t daimam
Atldress (number and sfreet, ciry, state, ZlPcode)
-22� 3� �
� ASSESSOR USE ONLY ' TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
- VALUE VALUE VALUE VAWE �
Land not exceeding 1(one) acre immediately �
surrounding residential improvements. (�) '
Otherland (p� �
�
Total land (line 7 plus line 2� (3)
Dwelling (4) � , .
Residential improvements - �
Garage (5)
Other improvemenis (6) �
Total improvemeNS (line 4 through lina � (7)
Total value (line 3 p�s line 7) (g) �
I hereby tertify ihe above is true, CorreCi, and Signamre of Assessor Date signed
camplete.
itymg aaion - Signature of Autlitor Date signed
�
STANDARD DEDUCTION ALLOWANCE
19_Pay19_ -
Lesser of V2 Homestead
Valuation or 52.000 S
SiqnaWre ot Auditor , \ Date ygP =� `
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