Homestead_Yeryara..�•�•, CLAIM FOR TY TAX FoRM YEAR
r�`"_ y; CREDIT/STANDARD DEDUCTION � Hcio � C�
�•.,�' State Form 5473 (R2/1-90) `
INSTRUCTIONS: See reverse side for filing instructions. /
CERTIFICATION STA
J. � � � I�'."�certi t �'—
I(We) • • ha on the 1 st day of March , 19
';We) occupied as our pnncipal place of residence the following described real property for which a Homestead
Property Tax Credit is hereby ciaimed: �We) owned ❑ Are buying under contract
�Have a beneficial interest in the entity that is liabie for the property taxes on the property and that owns the
p�operty or is buying it under a contract.
CONTRACT RECORDED
If buying on contracL Fee Simple Owner's Name „ •..
Recorder's office where contraci is recorded , . - Record Number Page
PROPERTY
= o a,a aa,
town,
-a-lo 3.�o A�
If any portion of the residential siructure or the land not exceeding one (1) acre that immediatety 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 .
ertify the above statements are irue. correct and
r. _ .
(Street, number, city, state and ZIP code)
r . _ • ' . .
ASSESSOR USE ONLY � � �� TFiUE TAX VAWE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding 7(one) acre immediately ' -
surrounding residential improvements (�) �
Oiher land (2)
Total land - line (7) plus line (2} (3)
Residentialimprovements.- _Dwelling (4)
Garage (5)
Oiher improvemenis (6)
Total improvements - line (4) ihrough line (6) (7) � .
Total value - line (3) plus line (7) (S)
I hereby certify the above is true, Signature of Assesor Date Signed
correci, and complete
Verifying Action - Signature of Auditor Date Signed
- 1989 Pay 7990
Lesser of 7/2 Homestead
Valuation or $2,500
Signature of
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991
Lesser of 1/2 Homestead
Valuation or $2,000
1�
7991 Pay 1992 79—Pay 19—
Lesser of 1/2 Homeslead Lesser of 7/2 Homestead
Valuation or $1,500 Valuation or $1,500
Date Sigi
S'�'