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dam; a CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
- CREDIT /STANDARD DEDUCTION
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
/' • �/
CERTIFICATION STATEMENT DEC 2 0 1991
I (We)uJcLe�,r,,,. c-�«C� ,� / r�c�c certify that on the t46YLp'f'�''QhTrrc�pp2J c9/
II (We) occupied as our principal place of residence the following described real property fdl''D6f11Ih ,99omestead
Property Tax Credit is hereby claimed: [j]I (We).owned ❑ Are buying under contract
El property 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
If buying on contract. Fee Simple Owner's Name
Recorder's office where contract is recorded Record Number Page
J:[�19�a�fU�Y�l:11il[�]C
Co my Township Taxing District (City, town township)
P rcel Number Legal Description
0 - or-
0 51 Ev /a /vw /e- -8 .93,4 -
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Township I County • F
hereby certify the above statements are true. correct and
state
ASSESSOR USE ONLY TRUE TAX ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
Land not exceeding i (one) acre immediately
surrounding residential improvements
Other land
Total land - line (1) plus line (2)
- Residential improvements - Dwelling
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
1991 Pay 1992
Lesser of 1/2 Homestead
19— Pay 19—
Lesser of 112 Homestead
Valuation or $2,500
(2)
Valuation or $1,500
Valuation or $1,500
(3)
Signature of A ditor
S
(4) -
(5)
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
Lesser of 1/2 Homestead
1990 Pay 1991
Lesser of 112 Homestead
1991 Pay 1992
Lesser of 1/2 Homestead
19— Pay 19—
Lesser of 112 Homestead
Valuation or $2,500
Valuation or $2,000
Valuation or $1,500
Valuation or $1,500
Signature of A ditor
S
Date Signed
1 /d.aa_ 91
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