Homestead_BlumCLAIM FOR HOMESTEAD PROPERTY TAX
° CREDIT /STANDARD DEDUCTION
i State Form 5473 (R2 15-92)
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INSTRUCTIONS: See reverse side for filing instructions.
CORM YEAR
HC70
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CERTIFICATION STATEMENT U . ;^ -• ;
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I (We) ell..YC ys� —y� CSiAStidi � certi that on t to 1 day of March, 19_
t it is hereby claimed:
I (We) occupied as our principal place of residence the following described real property for which a Homestead PropeSO
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l(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 under a contract.
CONTRACT RECORDED
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded -
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing district ilcity, town, township)
Parcel number
Legal description
If any portion of the residential structure or the land not exceeding one (1) acre that immediately sunounds that structure is used to produce income, describe the use and portion of
the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
certify the above statements are true, correct and complete.
Signature of aiman t
.ereby
I
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Address (number and street, city, state, ZIP code)
326 W. ELM TT. OAKLRND CITY /p(D/k".4 1(760
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON- RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assesor
Date signed
complete.
verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
$
Valuation or $2,000
Signature of Auditor
Date ssiig^ned
1
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