Homestead_Watson� _
�En� i� �
e� � CLAIM FOR HOMESTEAD PROPERTY TAX -
��� CREDIT/STANDARD DEDUCTION �
,�,��� State Porm 5473 (R2 / 5-92)
�ei� - ..
INSTRUCTIONS: See reverse side for liling instmctions. _
- . �• �- � - ' � CERTIFICI
i
_ �-_` �
' -�� r] [}� ORM YEAR
�r�y
�_ � �-HC10 ��
� ,IAN 151993
STATEMENT`�
I(We) 1 -- � certify that on the 7st day oi March. 79�
I(We) occupied our priricipal place of residence the following described-real pmperty for which a Homestead Property Tax Credit is hereby daimed:
❑. I(We) owned ❑ Are buying under conhact , , .
�ave a beneficial interest in the entity that is liable for the pmperty taxes on the property and ihat owns the property or is buying under a con[ract.
• CONTRACT RECORDED� � . � � '
If buying on contract, Fee Simple ownefs name ' . . � � - � �
Rewrder's office where wntract is recorded Record number - Page
- � � - � �S�' ��. PROPERTY DESCRIPi
County - , ' � _ Township � � . Tauing dis
Par el nu ber Legal description
�D �I �
If any portion of the residential structure or the land not exceeding one (7) acre that immediately surn
of the pmperty utilized to protluce income.
+
(city, town, township) �^
s�d to
\
. . . . . " -� � � ... �• /
` - _ � PROPERTY OWNED BY CLAIMANT IN OTHER�COUNTIES
Counry I Township
I hereby certify ihe above statements are true, correct and complete.
,P,��ess (number and street, ciry, state, ZIP code)
Signature
;ome, describe the use and portion
Township
� �
ASSESSOR USE ONLY � , � TRUE TAX � ASSESSED HOMESTEAD . NON-RESIDEN'fIAL �.
- � VALUE VALUE VALUE. VALUE -
Land not exceeding 7(one) acre immediately � - �
surrounding resideniial improvements. (�) - � -� �
Otherland (p) .
Total land (line 1 plus line � (g)
Dwelling (4) � . .
Residential improvements _ .. .
Garage (5) � ' � � _ .
Oiherimprovements (6) - ����, -
Total improvemenis (line 4 through line � (7�
Total value (line 3 p�s line � (g)
I hereby certity lhe above is true, correct, and Signature of Assessor Dare signetl
complete.
Verifying action - Signature of Autlitor - Da�e signed
JIAIVUHMU
19_Pay79_
Lesser of t/2 Homeslead
Valuation or $2,000
E
Signature ot Auditor � � \ , ^„ I -- -� � / �j
�l /ti^ n^ A l�% V ��