Homestead_Wise (3)e%��R
� g CLAIM FOR HOMESTEAD PROPERTY TAX �"
s��� CREDIT/STANDARD DEDUCTION
� �� State Fortn 5473 (R2 / 5-92)
�iu � '
INSTRUCTIONS: See ieverse side /or liling instmctions.
FO M YEAR
�0
pE� 2 61996 ,
. . . .. .. 1M ..i -. .
I� e) �jU1.AA .`J'Sl�rm'�c� l. 1 l 1.X4.h�nCn r certifyihM-6ffthc-�jtl�y`oTMarch,t9
�,, �.) occupied as our principal place of residence the following described real property for which a Homestead Property TaY Credit is hereby daimed:
L,u' I(We) owned ❑ Are buying under coniract . _ � . . �
❑ Have a beneficial imerest in ihe entity ihat is liable for ihe propeny taxes on ihe property and that owns ihe property or is buying under a contract.
� . �� � - CONTRACT-RECORDED.. . • - .- ' �
If buying on comract, Fee Simple owner's name . . . , , � - _ . .
Recorder'S ottice where contraa is recorded Retord number Page
_ � .
�
Couniy
Township
�
Parcel number L I description
DO ln - o ti 1� g 1- co � T 5 t.� 5 E.
It any portion ot the resi0entialSWCNre or the Wnd not exceetling one (1) acre that
o� ihe pfopefry utiliied to pfOduCe inCOme.
� : JI��
town,
— �- rv- :1 � J 1
ty surmunCS t�at strucwre is used to protluce
tlescribe the use and portion
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES ��
Counry Township Counry Township
�eby certify the above statemenis are true, correct and complete. n ure ot imam
Address (numberar�dsveeC ciry, sfate, ZlPcode)
ASSESSOR USE ONLY �� TRUE TAX � ASSESSED . HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediatety
surrounding resideniial improvements. (�)
Oiherland (p) � �. �
Total land (line 1 plus line 2� 3 I
l)
Dwelling (4)
Residential improvemenis -
Garage (5) ' - -
Other improvements (6) � �
Total improvements (line 4 through line � (7) -
Total value (line 3 pUs line 7� (g)
I hereby tertify �he above is tme, correct, and Signamre of Assessor Dare signed
complete.
��^tyirg action - Signature of Autlimr Date siqnetl
19_Pay19_
Lesser of 1/2 Homesiead
Valuation or $2,000
E
Signature of Au or /`�'�\ �/�
_..•_ MJ.t2 •� 1 0 \ U $Z/la- --<.�.
-'.e`�L . . ---- _ — . _