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d���.,, CLAIM FOR HOMESTEAD PROP.ERTY TAX
-� y � CREDIT/STANDARD DEDUCTION
:� State Form 5473 (R2/1-90)
'°�• � INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
J U�csoq
� ,�� �-s
AUDITOR
YEAR
I(We) qUf� �riA�� -- – — ertify that on the 1 st day of March , 19�
;(We) o upied as our principal place of residence the following described real property for which a Homestead
rProperty Tax Credit is hereby claimed: ❑ I(We) owned ❑ Are buying under contract
Have a beneficial interest in the entity lhat 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
office where contract is recorded
County
PROPERTY DESCRIPTION
' 1' ''�.iiii.c..c;cariiv
Parc I Number Legal Description � �_^ I a� 1�a 7
�.1 �— O 30�0 —0� �Li� o�iv�;� Q fo ex
If any portion of the residential structure or the land not exc eding 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
County Township County - Township
� hereby certify the above statements are true. correct and Signatu� �� o
number. city, state and ZIP code)
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-HESIDENTIAL
VALUE
Land noi exceeding 1(one)acre immediately
surrounding residential improvemenis (�) •
Otherland (2)
Total land - line (1) plus line (2) (3)
Residential improvemenis Dwelling (4) - - - - -
Garage (5)
Other improvemenis (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
1989 Pay 1990
Lesser of 1/2 Homestead
` Vatuation or $2,500
Signature of Auditor
STANDARD DEDUCTION ALLOWANCE
7990 Pay 1997
Lesser of 1/2 Homestead
Valuation or $2.000
I`�
1997 Pay 1992 19 — Pay 19 —
Lesser of 7/2 Homestead Lesser of 1/2 Homestead
Valuation or �1.500 Valuation or �1,500