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d.�•�•4 CLAIM FOR HOMESTEAD PROPERTY TAX
�� --, = CREDIT/STANDARD DEDUCTION �
:� State Form 5473 (R2/1-90) •
�'°�� ` INSTRUCTIONS: See reverse side for liling instructions.
CERTIFICATION STATEMENT
I (We)
FORM
HC10
:� �-�3
,
Y�
that on the 1 st day of March , 19�
rJVe) occupied as our principal place of residence the fol ing described real property for which a Homestead
Property Tax Credit is hereby claimed: . I(We) owned ❑ Are buying under contract
�Have a beneficial interest in the entity that.is liable for the property taxes on the property and that owns the
property or is buying it under a contract. .
CONTRACT RECORDED
PROPERTY DESC
Township
Legal
town,
_ ..�„�,�..
If.any portion of the residential struciure or ihe land not exceeding one (1) acre that immed ately su rou
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN
certify ihe above statements are true, codect and
Address (Street. number, city. stale
Lftn10 %70 2
1�P SLOO�QASSESSORUSEONLV
ER COUNTIES
TRUE TAX VALUE � ASSESSED VALUE HOMESTEAD VALUE
that struc-
NON-RESIDENTIAL
VALUE
Land not exceeding t(one) acre immediately
surrounding residential improvemenis (�)
� Otherland (2)
Total land - line (7 ) plus line (2) (3)
Residential improvements _ Dwelling _ _.(4)_.
Garage (5)
Other improvements (6)
Tolal improvements - line (4) through line (6) (7)
Total value - line (3) plus line �7) (8)
I hereby ceRify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
1 1989 Pay 1990
Lesser of 1/2 Homestead
Valuation or $2,500
Signature of
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1997 1991 Pay 1992 19—Pay 19—
Lesser of 7/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or $2.000 Valuation or $1,500 Vafuation or $1,500
D te Si ned
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