Homestead_Williams (27)`��'^"ry Y CLAIM FOR HOMESTEAD PROPERTY TAX
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a��'� CREDIT/STANDARD DEDUCTION �
. .�y ,/�� Siate Form 5473 (R2 / 5-92)
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INSTRUCTIONS: See reveise side lor liling inst�uctions.
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I(We) , � v�y�� certify ihat on ihe 7 st day of March, 19_
) occupied as our principal place � e o iowing described real property for which a Homestead Property Tax Credit is hereby daimed:
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V I(We) owned ❑ Are buying under contrad
❑ Have a beneficial interest in the entity thai is liable for the property taxes on ihe property and thai owns the propehy or is buying under a contract.
If buying o� contracC Fee Simple owner's name
ReCOrder's oflice where Coniract is recorded
PROPERTY DESCRIPTION
Counry � Township Ta.ing tlistrict (ciry, town, fawnshlp)
Parcel nu ber Legal description
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If any portion of the residenGal stmcWre or the land not exceeding one (7) acre that immediately surmunds Ihat slructure is used to produce income, describe the use and portion
of Ihe property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Couniy Township County
eby certify the above siatements are vue, correct and wmplete. Signanre ot ciaimam
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Address (numberaridstreet. ary, stare, ZlPmde)
Township
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvements. (�� �
Oiherland (p)
Total land (line 7 p/us line � (3)
Dwelling (4)
Residential improvements
Garage (g) .
Other improvements (6)
Total improvemenis (line 4 (hrough lina � (7)
Total value (line 3 p�s line 7) (g)
I hereby cenify the above is true, correct, and Signa:ure of Asseswr Date signed
complete.
Veriying action - Signamre ot Audimr Date signed
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STANDARD
79_Pay79_
Lesser of V2 Homestead
Valuation or 52.000
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