HomeMy WebLinkAboutHomestead_Keen.y�� -
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d�•�•, CLAIM_FOR HOMESTEAD RROPERTY TAX .� FoRM _. vEaR
�� y`4 CREDIT/STANDARD DEDUCTION Hcio a
� State Form 5473 (R2/1-90) ` �
w.•' '°�• �� INSTRUCTIONS: See reverse side lor filing instructions. �
CERTIFICATION STATEMENT � i i� �„,;,_ _
I(We) I.J�a `-�' T�4�M� - certify that on the 1s ay of M�rc V 19 �
`(We) occupied as our principal place of residence the following described real property foA�i���2stead
Property Tax Credit is hereby claimed: ,�(We) owned ❑ Are buying under contract
��Have a beneficial interest in the entity thaC is liable for the property taxes on the property and that owns the
property or is buying it under a contract.
CONTRACT RECORDED
on contracl. Fee Simple Owner's Name
's office where contract is recorded
PROPERTY DESCRI
County
Record Number � Page
Parcel Number Legal Description
0�9 - oaoo� • oo �� � 3
If any portion of the resideniial siructure or the land not exceeding on (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 -
hereby certify the above siatemenis are true, correct and � I Signa re � Q/J
omplete. - X ��-
�ddress !Street, number, city, state and ZIP code)
K I I S N� M 82� p/LU�c,�to,,l �/ �(, 70
ASSESSOR USE ONLY �. � TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
NON-RESIDENTIAL
VALUE
�and not exceedinq t(one) acre immediately '' � ��
surrounding residential improvemenis (�)
Oiherland (2)
Total land - line (1) plus line (2) (3)
- Resideniial improvemenis - Dwelling - (4) — � - � - � � -
Garage (5)
Other improvements (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 Date Signed
7989 Pay 1990
sser of 1/2 Homestead
Valuation or $2,500
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 �7,500 Valuation or S7,500
Signature of Auditor /� � � f�I � a't�eg i�
l M /1.lIL "I � J�J1 � n