Homestead_Woolard/ea' ��� CLAIM FOR HOMESTEAD PROPERTY TAX
�a. �`' CREDITISTANDARD DEDUCTION
State Fo�m 5<731R2 i 5�92)
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INSTRUC iIONS: See ieverse side la� liling insfructions.
FORM YEAR
HC10
� 1�'�'el �.\d'(_J.A/.Xl MA ��h�— cenity tha� on the 7st day of March. 19
�e) qccupied s our principal place of residence Ihe following described reat pwperty lor which a Homeslead Property Tax Credii is hereby claimed:
/
JI (We) owned ❑ Are buying under cornrac�
❑ Have a benelicial interesl in Ihe en�i�y Ihal is liable br �he property �axes on Ihe pmperty and ihat owns Ihe pro(�jK yFis�uying��P! a Conlract.
:!
If buyfng on coniract. Fee Simple on�ner 5 name
Recorder'S oHice where conlract is recordetl
Counly
It zni
OI Ih�
�' - •
TownShip
� LegalOescripPOn
1�3 s�o
ihe resiCeNial ,Imcime or the Wnd nol eMCeetling o ( t',
utAizeO to orotluce incUme.
PROPERTY
' � `' ' � ' � - s PROPERTY OWNED BY
Ceunty Township
1
�reby cerlily �he above stalemenls are Irue, correcl and complele. �
tltlresYRrumber antl streel. c�fv. sldre. Zl�ode) /
� ASSESSOR USE ONLY ' � '
Land not exceeding 7(one) acre immediately
surrounding residenlial impmvemenis.
Olh?rland
Total land (line I plus line �
Dwellmg
Residen lial 1 mprovem en�s
Garage
O�ho� improvement5
To�al improvemen�s (�ine d (hrough line �
Total value (iine 3 p�s �ine 7�
1 hereby certify the above is true. correcl, and
camplete.
Veeifying aCtion � Sgnature ol Autlilor
19__Payt9_
Lesser ol U2 Homeslead
Valuation or $2.000
immedialely surrounds ihal simcWre is used to prOduce intome. descnbe Ih? use an0 pOriion
TRUE TA% '
VALUE
1�1
121
(3)
I41
�5�
(6)
1�1
(8)
Signature ol A55essor
MANT IN OTHER COUNTIES �
Couniy
Sf re ol clai
ASSESSED HOMESTEAD
VALUE VALUE
..��•
5
ALLOWANCE
TownShip
NON-RESIOENTIAL
VALUE
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:�T�'� V:
Date signetl
Date s�g�ed
SignaW�e al Autlnor I Daie signetl