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CLAIM FOR HOMESTEAD PROPERTY TAX vEaR
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��'"" y ' CREDIT/STANDARD DEDUCTION . '� Hcio
`+�' State Form 5473 (R2/1-90) ' "
'°" INS,TRUCTIONS: See reverse side for (iling instructions. . � ,
CERTIFICATION STATEMENT
I(We) II 1 IYI.(°.N- Xlil�� _ certify that on the 1 st day March 19 � s
�Ve) occupied as o principal place of residence the following described real property for whic{y(��BIkTr6��
Property Tax Credit is hereby claimed: �❑ I(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 buyirig it under a contract. �
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name � .
Recorder's office where contract is recorded� ' ' Record Number Page
: - PROP.ERTY DESCRIPTION
Couniy " Township Taxing Distric
�'c� Nu��� � _ � Legal Description (�� Q _ � _� _ f h " 3.7 � L
1- �b.�.er• v
If any portion of the residential'structure 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 Bl'•CLAIMANT IN OTHEFi COUNTIES
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� ASSESSOR USE ONLY' TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDEHTIAL �
VALUE
Land noi ezceeding 7(one) acre immediately
surrounding residential improvements (�)
Oiherland (2)
Total land - line (7 ) plus line (2) (3)
- Resideniial improvements - Dwelling (4) � - - � —
Garage (5)
Other improvemenis (6)
Total improvements - line (4) ihrough 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 oi Audilor Date Signed
1989 Pay 1990
Lesser of 7/2 Homestead
Valuation or $2,500
Signature of Auditor
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 1997 Pay 7 992 7 9— Pay 19 —
Lesser of 7/2 Homestead Lesser of 7/2 Homestead Lesser of 7/2 Homestead
Valuation or $2,000 Valuation or �1,500 Valuation or $7,500
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