Homestead_Bruce (3)CLAIM FOR HOMESTEAD PROPERTY TAX'
s� CREDIT /STANDARD DEDUCTION
,,�• State Form 5473 (112 / 5 -92)
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INSTRUCTIONS: See reverse side for filing instructions.
Fi +
F-Fr AR
HC Cut �9
N. :R 7 _ - certify that on the 1 st day of March, 19
occupied as our principal lace of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed,
i(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 -
II buying on contract, Fee Simple owner's name - - - -
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION '
County _
Township
Taxing district (city, town, township)
Parcel number
Legal description
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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
TRUE TAX
VALUE
County
Township
County
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Township
eby certify the above statements are true, correct and complete.
Signature imam
yc�1,
Address ( u ber dstreet, city. state, ZIP code)
(2)
v f G)bSa ✓ J'; 04 IKGA r( C-%
IY766 0
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE.
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
Signature of Auditor
Other land
(2)
Total land (line i 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 plus line �)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
fying action -Signature of Auditor
�s
I Date signed
STANDARD DEDUCTION ALLOWANCE
19 _Pay 19_
Lesser of 1/2 Homestead
S
Valuation or $2,000
Signature of Auditor
Date signed