Homestead_Church (3)• CLAIM FOR HOMESTEAD PROPERTY TAX
:z CREDIT /STANDARD DEDUCTION
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
FORM YEAR
RC,O q o-
certify that on the 1st day of March , 19 4D•
We) occupied as our principal place of residence the Poll ng described real property for which a Homestead
loperty Tax Credit is hereby claimed: I (We) owned 0 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
El 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
PROPERTY DESCRIPTION
Township I I Taxi? DistrC�N (Cq(y, town,
arc I um er ` �_�� Legal sc o
O j/
If any porti esi i cture or the land ncQxceecling one.(1) acre that immediately surrounds that struc-
ture is use p c scribe the use and portion of -the property .utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNIIES
cRNO g3o
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
ZMP. 3070 P, - VALUE
J
Land not exceeding 1 (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
Valuation or $1,500
19 —Pay 19—
Lesser of 1/2 Homestead
Valuation or $1,500
(2)
Signature of Auditor
(3)
.(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 112 Homestead
Valuation or $2,500
1990 Pay 1991
Lesser of 112 Homestead
Valuation or $2,000
1991 Pay 1992
Lesser of 1/2 Homestead
Valuation or $1,500
19 —Pay 19—
Lesser of 1/2 Homestead
Valuation or $1,500
Signature of Auditor
Date Signed