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.���• CLAIM FOR HOMESTEAD PROPERTY TAX
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d/�E
;P , � CREDIT/STANDARD DEDUCTION
•` .� Stale Form 5473 (R2/1-90)
�'°" ` INSTRUCTIONS: See reverse side !or liling ins(ruc(ions.
CERTIFICATION STATEMENT
� �we� �1�� �r� �
,Ne) occupied as our principal place ol
�rly Tax Credit is hereby claimed:
�'� q�
FORM Y^EAR
HC10 7
cerlity that on ihe 1 st day of March , 19 �
Ihe f wing described real properly for which a Homestead
I(We) owned ❑ Are buying under contracl
� Have a beneficial interesl in the entiry lhal is iiable (or (he property laxes on ihe pwperty and Iha� owns Ihe
property or is buying it under a conlract.
CONTRACT RECORDED
If buying on conlract, Fee Simple Owner's Name
Recorder's oilice where contracl is recorded
PROPERTY DESCRIPTION
Counly
Record Number
lownsl�ip)
Page
P rc I umb r Legal Descriplion
��h4)G �m � ac� i� �
If any portion of the residential siruclure or ihe land nol exceeding one (1) acre that imme ialely surrounds that struo-
ture is used to produce income describe Ihe use and porlion ol lhe property utitized ro produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Counly Township Coun�y Township
,ereby certily Ihe above slatemenls are Irue, conecl and SignaWre
complele.
Address (Slreei, number, ciry, stale and ZIP code)
ASSESSOR USE ONIY TRUE TA% VALUE ASSESSED VALUE fiOMESTEAD VALUE NON-RESIDENiIAL
VALUE
Land not exceeding 1(one) acre immedialely
surrounding residential improvemenis ( � 1
011ier land (2)
Total land - line (1) plus line (2) (3)
Residenlial improvemenls Dwelling (4)
Garage (5)
Olher improvements (6)
Tolal improvemenls - line (4) tluougli line (6) (7)
Tolal value - line (3) plus iine (7) (8)
I hereby certify the above is true, Signalure ol �ssesor Dale Signed
correct, and complele
Verilying Aclion - Signature ol Auditor Uate Signed
' 7989 Pay 1990
Lesser of 1!2 Homeslead
Valuation or $2,500
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991
Lesser oi 1/2 Homestead
Valualion or $2,000
� —
1991 Pay 1992 19 — Pay 19 —
Lesser ol 1/2 Homeslead Lesser ol 1!2 Flomestead
Valualion or $1,500 Valuation or $1,500
Signalure of Audilor �� i�e � yney��
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