Homestead_Wellse%�'"'�°, CLAIM FOR HOMESTEAD PROPERTY TAX �' M' YEAR
=.a�'� CREDIT/STANDARD DEDUCTION C`��o��' ��
,�`'� State Form 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side tor liling ins(ructions. �� 2�� ta�7
' CERTIFICATION STATEMENT ` � � �, e h. -
1(We) e _ c� certify that on the'1�T95y�o�'FA�rch, 79
�) occupied as our principal place of residence the following described real pmperty tor which a Homestead Property Tarz Credii is hereby claimed:
(We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the eniity that is liable for the pmperty taxes on the pmperty and that owns the property or is buying under a contract.
CONTRACT RECORDED " - �
If buying on con�rac�, Fee Simple owner's name . . . -' ' . �
Recorder's oHice where contract is recortled Record number Page
PROPERTY DESCRIPTION
iownship �. � razfng�str�tiLiry, town,
Parcel number � Legal
�i i-�iiu��ucs- i ii s� °r -T vvru. ��ti�-�.
If any portion ot ihe residentiai stmcture or Ne lantl not exceeding one (7) aae that immediatety surrounds that struciure is used to produce income, descnbe Ne use and ponion
of the properry utilized ro produce income.
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON•RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately -
surrounding residential improvements. ��) -
Oiherland (2)
Total land (line 7 plus line 2� (3) �
Dwelling (4)
Residential improvemenis
Garage (5)
Other improvements (6)
Total improvemenis (line 4 through lina � (7)
Total value (line 3 p�s line 7� (g)
1 hereby cenify Ihe above i5 tme, correCi, and Signature ot Assessor Dare signed
complete.
Ventyirg action - Signa;ure of Auditor Dare signed
STANDARD DEDUCTION ALLOWANCE �
19_Pay19_
Lesser of 1/2 Homestead
' Valuation or 52,000 S
Signature o� Auditor Date signed