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d�?^•y CLAIM FOR HOMESTEAD PROPERTY TAX �
�" y � CREDIT/STANDARD DEDUCTION
�•` .� State Form 5473 (R2/1-90)
�'°�• � INSTRUCTJONS: See reverse side lor (iling instructions.
I (We)
CERTIFICATION STATEMENT
that on the 1
FORM YEAR
HC10 ql
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19�
�(We) occupied as our principal place of residence the tollowing described real property (or which a Homestead
roperty Tax Credit is hereby claimed: � 1(We) owned �7Are.buy ng under�contract
AUDiid� "
� 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 contraci.
CONTRACT RECORDED
on contract, Fee Simple Owner's Name
where contract is recorded
PROPERTY DESCRIPTION
Townshi �/ Taxin S�ri t(Cit , town,
ta„""
Legal Description /� c /1 r�a�!
� .�. �1 �T
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 BY CLAIMANT IN OTHER COUNTIES
Township County �
� �� _
certity the above statements are true, correct and Signatu
� .�0�,1_'/x_ �
s(Street, number, city, state and ZIP code) /%
�/
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
NON-RESIDEHTIAL
VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvements (�l
Otherland (Z)
Total land - line (1) plus line (2) (3)
Residential improvements Dwelling (4)
Garage (5)
Other improvements (6)
Total improvements - line (4) through line (6) (7)
Total vatue - line (3) plus line (7) (8)
I hereby certi(y the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Audilor Date Signed
1989 Pay 1990
�ser 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 t/2 Homestead
Valuation or $1,500 Valuation or $1,500
Signature of Auditor � I (� `� I Da� :
Aiwv-r� V�.i