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a� CLAIM FOR HOMESTEAD PROPERTY TAX FORM EAR
CREDIT/STANDARD DEDUCTION Hcio
State Form 54473 (R2 / 5 -92) ly,5-1
INSTRUCTIONS: See reverse side for filing instructions.
/ 1 \ A.d! V / vX/ V`x NlN L / r certify that on the 1st day of March. 19
as our principal place 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 properly taxes on the property and that owns the Tots bu u er contract.
CONTRACT RECORDED
II buying on contract. Fee Simple owner's name
Recorder's oHice where contract is recorded I ecorq ppvtlXPOO Page
PROPERTY DESCRIPTI
County Township County I Township
I
County Township
Taxing disc (city low.; w. i
ASSESSOR USE ONLY
r I umber _ I Legal description
�f
(/
11 any portion of the residential structure or the land not exceeding One ( 1 acre Ihat immediatehi urrounds that structure is used to produce income.
of the property utilized to produce income.
bescribe the use and portion
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County I Township
I
�iy certify the above statements are true. correct and complete. I Sign .ure f claimant
Address (number and street. city. stale. ZI code
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
I (1)
Other land
(2)
Total land (line I plus line Z)
(3)
Residential improvements
Dwelling
I (4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3plus fine/)
(g)
I hereby certify the above is true. correct. and
complete.
Signature of Assessor
I Date signed
Verifying action Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 _Pay 19_
Lesser of 1/2 Homestead
S
Valuation or 52.000
Signature of Auditor
Date signed