Homestead_Broshearsea E CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 15-92)
INSTRUCTIONS: See reverse side for filing instructions.
FILED FORM pYE�AR
MAY 101993 Hcio L I J
awe -e!. k:
LU • . 4 � � - certify that on the 1 st day of March. 1913
as our principal place of kJidence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ 1 (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 '
It buying on contract, Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
- PROPERTY DESCRIPTION
County
Township
Taxing dis t (Cip; t n+a,
township)
Parcel number
Legal description
/1 a
Other land
p°�� J
Q
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line b)
(7)
Total value (line 3 pUs line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
rug anion - Signature of Auditor
r_
Date signed
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
5
ALLOWANCE