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a� `s CLAIM FOR HOMESTEAD PROPERTY TAX
o-E CREDIT /STANDARD DEDUCTION
State Form 5473 (R215 -92)
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INSTRUCTIONS: See reverse side for filing instructions.
n A Ic 'nc 7 certify that on the 1st day of March, 19
occupied as ou . r. cipal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
((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
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded - Record number Page
e, PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township)
.r�Parcel number
Legal description
If any portion of the residential structure or the land not exceeding one (1) arse 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
County
Township
County
Township
®eby certify the above statements are true, correct and complete.
Signature of claimant
Signature
Address (number and street. ary, state. ZIP code)
Al. J41
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Signature
Datesignetl
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 6)
(7)
Total value (line 3 pbs line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
&ing action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
S
Signature
Datesignetl
=
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