Homestead_Wildt (7)e�'�'� 4 CLAIM FOR HOMESTEAD PROPERTY TAX .
_���� CREDIT/STANDARD DEDUCTION '
,�,` � State Form 5473 (R2 / 5-92)
Gi.
I (We)
I (We)
INSTRUCTIONS: See �everse side /or filing instructions.
/
as our principal place of residence the following described real
FORM YEAR
Hc,o / 99�
�����
IFM .. ' . ' . .
N��ertify? at on ihe 7 st day ot March. 79�
i H�teaQ�p�rtyj�,Credit is hereby daimed:
I(We) owned ❑ Are buying under con�ract AUDITOR �
Have a beneficial interest in the entity that is liable tor ihe property taxes on the property and that owns lhe property or is buying under a contract.
� - �CONTRACT�RECORDED: . . . . . �
If buying on contract, Pee Simple owner's name ' - . .
Recorder's oHice where coniract is recorded Record number Page
County /
C�' / GiSo../
� . PROPERTY DESCRIPTION
Township /�
/�/-t To ic rg
town, rownship)
Parcel number Legal description
oa6 - oa�S/_ oo Or- � �vc.� �s-z-ii(i, gS Hc�
It any portion ot the residential sWcture or the land not exceeding one (1) aae ihat immedia[ety su« ounds that structure is used to produce inco , tlescribe the use and portion
of the pmperty utilized to produce income.
ASSESSOR USE ONLY _ TRUE 7AX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE. VALUE _ VALUE
Land not exceeding 7(one) acre immediately
surrounding resideniial improvements. (�) �
Otherland (2�
Total land (line 7 plus line � (3�
� Dwelling (4) � � �
Residential improvemenis
Garage (5) _ -
Other improvements (6)
Total improvements Qine 4 through line � (7)
Total value (line 3 p�s line 7� (g)
I hereby certify the above is true, correct, and Signature of Assessor Date signed
complete. �
Veritying action - Signamre of Audiror Date signed