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�h, CLAIM FOR FiOMESTEAD PROPERTY TAX
, : CREDIT/STANDARD DEDUCTION
;' State Form 5473 (R2/1-90) "
_ INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT . -
I(We) '�.��__����'�{,(/n'� certify that on the 1 st day of March , 19�
"Ne) occupied as our pri ipal place of residence the foliowing described real property for which a Homestead
roperty Tax Credit is hereby claimed: L1d' 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 buying it under a:contract. . .
CONTRACT RECORDED '
on contract. Fee Simple Owner's Name
's office where contract is recorded
Countyi T� nship _ Taxing District (City, town,
�a�el Numb ,GG Legal Description D
ry
If any portion of the residential structure or the land not exceeding one (t) acre aLimme
ture is use e scribe the use and portion of the property utilized to prc
����
y surrounds that struc-
income.
CA,✓0 ,5' 30 2 � s.it P So so � . . . . - -
� � ASSE$SOR USE ONLY - " - TRUE TAX VAWE ASSESSED VALUE HOMESTEAD VAWE NON-RESIDENTIAL
+ � • ' ' VALUE
, landnotexce`edingl(one)acreimmediately _ _
surrounding residential improvements (�)
Other land (2)
Total land - line (7) plus line (2) (3)
Residential improvements.. _ Dwelling (4) . . .
Garage (5) �
Other improvements (6)
Total improvements - line (4) through line (6) (7)
7otal 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 Date Signed
1989 Pay 7990
:r of 1/2 Homestead
duation or $2,500
Signature of
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991
Lesser of 1/2 Homestead
Valuation or $2,000
1991 Pay 1992 19 — Pay 19 —
Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or $1,500 Valuation or $1,500