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e�^��°a CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
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�, Sta;e form 5a73 (R2 / 5-92) � � �
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INSTRUCTIONS: See reverse side foi /iling instructions.
FORM YEAR
HC10
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I(We) __ \ � . _ . certify that on t e 7st day of March, 19_
�'We) occupied as our r cipal pl e ot residence the following describedreal property for which a Homestead Proper��i �er daimed:
S
�(We) owned ❑ Are buying under contract � ,, � AUDITOR
� I Have a beneficial inierest in ihe entiry ihat is liable for the property taxes on the property and ihat owns the property or is buying under a contract.
�- - - � - � - CONTRACTRECORDED
If buying on contract, Fee Simple owner's name- _
Recortler's oHice where contraa is rewrded Record number Page
Coun.y
Parcel num6er
I any tlion of I
County
• PROPERTY DESCRIPTION
Tovmship , T ng distriti.�ary. town, rownship)
- �� �. �., ... � -�- _.
Legal deuription
AU—l� •
strucNre or Ne land not exceeding one (7) aue that immediatety surmunds that siruciure is used to produce income, descri6e the use antl poeion
ice income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Township County
certify the above siatements are true, correct and complete. 's�9namre ot
(num6er and streel. ary, slate. ZIP mde)
Township
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE. VALUE VALUE
Land not exceeding 1(one) acre immediately
surroundinq residential improvements. (�)
Oiherland (p)
Total land (line 7 plus line Z� (3)
Dwelling (a) � �
Residential improvements
Garage (g) -
Oiher improvements (6)
Total impmvemenis Qine 4 Ihrough lina � (7)
Total value (line 3 p�s line 7� (g) '
I hereby cenify ihe above is true, correct, and Signawre of Assessor Date signed
complete.
Verityirg action - Sgnature of Auditor Date signetl
STANDARD DEDUCTION ALLOWANCE
79_Pay79_
Lesser of 1/2 Homestead
Valuation or 52.000 S
S' aWre of Audiror Dare signetl