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.�•n•�•" CLAIM FOR HOMESTEAD PROPERTY•TAX
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;'"` y ; CREDIT/STANDARD DEDUCTION _,
� State Form 5473 (R2/1-90)
,' '•�• �� INSTRUCTIONS: See reverse side lor filing instructions.
CERTIFICATION STATEMENT
FORM_ __ , �
HC10
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� Ne) L � certify that on the 1 st day of March , 19 �
` I(We) occupied as our princip lace � idence the following described real pro,p/erty for which a Homestead
Property Tax Credit is her�'clai�rR��: ❑ I(We) owned l�d Are buying under contract
�Have a beneficial interest irtbhe entity that is liable for the property taxes on the property and that owns the
property or is buying it under a contract
If buying on contrac�.
Township
CONTRACT RECORDED
PROPERTY DESCRIPTION
Record Number
'Lvu_ . �! . !o
town,
P�SS
Parcel Number egal Description
0�9- o o,� 7 l�tn,�fa�,� 7 �.c � 9 F_ �l 4- �o�`la l� i I�FJ� �.t �_ /
If any portion of ihe residential structure or the land not exceeding one (1) a�mediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
I hereby certify the above
PROPERTY OWNED BY CLAIMANT IN OTHER
Township County
are true. correct and I Signature
Address (Sireet. number, city. state
ES
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
" ve� nF
�and noi exceeding �(one) acre immediately
surrounding residenlial improvements (�)
Otherland (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)
Total value - line (3) plus line (7) (8)
I hereby ceRify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
1g89 Pay 7990
Lesser ot 1/2 Homestead
Valuation or $2,500
Signature of
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 1997 Pay 1992
Lesser of 1/2 Homestead Lesser of 7/2 Homestead
Valuation or $2,000 Valuation or 57,500
19—Pay 79—
Lesser of 1/2 Homestead
Valuation or 57,500
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