Homestead_Viton,
4a�-3' ; CLAIM FOR HOMESTEAD PROPERTY TAX M YEAR
� CREDIT/STANDARD DEDUCTION � �
3�� ��' State Form Sa73 (R2 / SA2)
�'� SEP 0 9 1996
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INSTRUCTIONS: See reverse side for liling instructions. •
� � � ' � � "'- CERTIFICATION STATEMENT •. . - � _ -
Cy�� \ r
��We) \0_—Q � l. .�,... , certify that on the 1st day of March, 79
�) occupied as our principal place of residence the following described real property for which a Homestead Property Taz Credit is hereby claimed:
�I(We) owned ❑ Are buying under contract
Have a beneficial interest in ihe entiry thai is liable for the property taxes on the property and ihat owns [he property or is buying.under a contract.
" . CONTRACT RECORDED � - � - � -
If buyi(g on conirac6 Fee Simple owner's name -
Recortler's oHice where contraM is recordeC pecortl number Page
- � " PROPERTY DESCflIPTION - � -
Counry Township T�+i�q district (ciry. mwn. lownship) �'
ParCel number I Legal desCription
��� '���S�O'�Zl
Ii any ponion of the residential strucNre or Ne lantl not exceetling one (t) acre that immediatety surwunds ihat sWCture is used to produce income, deSCriDe the use and portion
oi Ihe property uWized to produce income. "
ASSESSOR USE ONLY TRUE TAl( ASSESSED HOMESTEAD NON-RESIDENTIAL �
VALUE - VALUE VAWE , .. VALUE
Land noi exceeding 1(one) acre immediately � -
surroundin9 residential improvements. (�) _ - `�
Otherland . (2)
Total land (line 7 plus line 2� (3)
Dwelling (4)
Residential improvements
Garage (5) - �
Other improvements (6) �
Total improvements (line 4 th�ough line � (7)
Total value (line 3 p�s line � (g) �
I hereby Certify the above is true, correci, and Sgnature of Assessor Date signetl
complete.
�irg action - Signature of Audimr Date signed
L
79_Pay19_ � I
Lesser of 1/2 Homestead .
Valuation or $2,000 S
Signamre o Audi:or � � � —
h�__ 1 � �