Homestead_Youngad i CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
.. State Form 5473 (R2 / 5-92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM AR
HC70 .
` I (We `l V certify,thaI on tha 1st day of March, 19
- _,',v as our principal place described r a ropenly for ich a Homestead Property Tax Credit is hereby claimed:
-v
, owned 0 Are buying under contract
R
_ficial interest in the entity that is liable for the properly taxes on the property and that owns grope y or i der a contract.
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7••, nv1 .H.�,nn 1!1,^ r,7- carCONTRACT,-RECORDED.vq.,� t -- i'W'�' ,.r at
- rh r,euYei� -• rici:YF"�`, hiA' a.�:
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded " ` 'rtyrn o page
' loR
PROPERTY DESCRIPTION
County Township
County
Township
Taxing district (cif own, wig)
P rce ben
- 33s- o0
Legal description
II any portion of the residential structure or the land not exceeding one (t) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the properly utilized to produce income.
+ � P b street. dry. state, ZlP code)
Land not exceeding lone) acre immediately
- �0 -/�3 -•
33a� -GAS
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES ^
County Township
County
Township
• ;- N6N- RESIDENTIAL -,1 '
-
VALUE .
-• ^ ^ ^' +v, the above statements are true, correct and complete.
Sgna re of claimant
+ � P b street. dry. state, ZlP code)
ASSESSOR USE ONLY
TRUETAX
ASSESSED
HOMESTEADS `;=
• ;- N6N- RESIDENTIAL -,1 '
-
VALUE .
VALUE
VALUE -;:
•cxayALUE.a` t.. - "'
Land not exceeding lone) acre immediately
9
surrounding residential improvements.
Other land'
(2)
'y
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
;tx w,) o�'�.?t
�'..-
Residential improvements
�c
'+tom =:`t: M' •y.,.;
Garage
(5)
•,1a�- 41'`tsK'.!*a
Other improvements
(8)
" ' :a.•,.q
Total improvements (line 4 through line 6)
(y)
Total value (line 3 plrs line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed"
STANDARD. DEDUCTION ALLOWANCE +;; s, �,�..; -. .. - ^.` ,{ -';• - t; - -"
19 Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
$
Signature of Auditor
Date si
g,7-/,g /
9
• .