Homestead_Williams (32)�E n�� .
e� `, CLAIMfOR HOMESTEAD PROPERTYTAX
�>�': CREDIT/STANDARD DEDUCTION
.�;�'� State Form 5473 (R2! 592)
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INSTRUCTIONS: See reverse side lor tiling instrucfions.
FORM YEAR
° R3
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� � � �- CERTIFICATION STATEMENT
I (We) �Q . �(- �awn.Ct �I � l. I�J�XX�i/�-0� � certi a 79 �
,e) occup as our principal place ot residence the following described reat property for which a Homestead Prope e i i hereby Gaimed:
I (We) owned ❑ Are buying under coniract � .
❑ Have a beneficial inierest in the entiry ihat is liable tor ihe property taues on ihe propeny and that owns ihe property or is buying under a contract.
CONTRACTRECORDED-
11 buying om m�tract, Fee Simple owner's name . �
Recorder's ottice where contraa is recorded Record number Page
PROPEPTY
County
IFt iry rown, fowns rp)
��7 '
Parcel number Legal description '
��-�3s�� C��- € - (�-a-io . �����
I( any portion ot the residential stmcture or the land not exceedinq one (7) aue lhat immediately sunounds that structure is used ro produce income, descnbe the use and portion
of Ihe property utitized m produ[e income.
o��-ia -G �-yo i - o�.� 5�/ -�ag'
ASSESSOR USE ONLY .- TRUE TAX ASSESSED HOMESTEAD NON-RESIDEN'fIAL
� VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvements. (�)
Otherland (p)
Total land (line 7 plus line Z� (3) _ ___
Dwelling (4) / � B6�
Residential improvements �� .
Garage (g) (� �
\! � �y/.3Q
�` V I
Other improvemenis (6) �1 —\
Total improvements (line 4 through lina � (7) �� � l T //�v
i �
7otal value (line 3 p�s line � (g�
I hereby certify the above i5 �rue, Correct. and Signature ot Assessor Date signetl
complete.
Verityirg action - Sgnature of Auditor Date signed
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�
19_Pay19_
Lesser of 7/2 Homestead
valuation or 52,000
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S
ALLOWANCE
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1
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