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Nn .
� CLAIM FOR HOMESTEAD PROPERTY TAX
' = CREDIT/STANDARD DEDUCTION
State Fortn 5473 (Rb 18-00)
S ,.,. P
� INSTRUCTIONS: See reverse side for filiig insWctions.
FORM� � —, YEAR
�
.� � � t ,� �/6 3 .
�
SEP 0 �� 2001
I(We) / V V / l.(ilLR� / ' p/(/ /�rtify that on lfie`7st�Bay oYMarchy20 I
I(We) occupied as r principal place of residence the foliowing describ re I property for w' a Homestead Property Tac Cred'R is hereby daimed:
❑ I(We) owned ❑ Are buying under contrad
�ave a benefidal interest in the entity that is liable tor the property taxes on lhe property and ihat owns the praperty or is buying under a cantrad.
If buyirg on coniract, fee Simple ownels name
Recordefs ofice where contraG is recorded ._
Record number Page
`�.� „„i:'`'." ��'.��-�,.�-��'����i'��^�,'�'- ",si...�-� �PQOPERI�ESCRIPTION�.�i,,-'��„`�1.�. .b �'� ,,.ar. ���
Counry TownshiP . Taring EisVid (cify � )
Par I n mber Legal desaipUon
-oo � . �J - a- _o . 33 iy
If any portion ol ihe residentlal sW Uure or the lantl rrot exceedin9 one (1) acre Nat imme0iafey surtounOS that sWClure is used to produce inoort�e, tlescriDe the use and porUon
of Ne property utilizetl lo pioduce i�ome. � �- � �� ' .
20 _ Pay 20 _
Lesser of 12 Homestead
Vatuation or 56,000 $