Homestead_Woolems.��•T��• CLAIM FOR HOMESTEAD PROPERTY TAX
d�P 4` CREDIT/STANDARD DEDUCTION ..
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' State Form 5473 (R2/1-90) �
'°�° �. INS.TRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
��� ^a YEAR
FfCtO�—J • C�
t`�l�ti 15 1991 /
place of residence the following described real property for which a Homestead
Property Tax Credit is hereby claimed: � (We) owned ❑ Are 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
If buying on contracL Fee Simple Owner's Name
Recorder's office where contract is recorded Record Number Page
�
PROPERTY DESC
T
township)
Parcel Number Legal Descripti
coc� -oaao5 `�� S 5-a-io 9�� ra�
If any portion of the resideniial siructure or the land not exceeding one�(1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Township County
—
I hereby certify the above, statemems are true. correct and
(Street, number, city, state and ZIP code)
� z .� .. �_ -� > t9 0 _ . .
re
.
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
� VALUE
Land not exceeding 1(one) acre immediately
surrounding resideniial improvements (�)
Oiher land (Z)
Total land - line (7 ) plus line (2) (3)
Residential improvements� Dwelling - (4) - - � - -
Garage (5)
Other improvemenis (6)
Total improvements - line (4) through 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 Dale Signed
1989 Pay 1990
Lesser of 1/2 Homestead
Valuation or $2,500
��
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 1991 Pay 1992 79—Pay 79—
Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or �2,000 Valuation or $1,500 Valuation or $1,500
Date Signed
3-�s-�