Homestead_Grubb (4)CLAIM FOR HOMESTEAD PROPERTY TAX
a y4° CREDIT /STANDARD DEDUCTION
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
KIIFIUAIIUN SIAItMENI
EAR
1
SEP 15 1992
I (We) certify that on the 1st day of trpiT T9 ��
11 (We) occupied L our principal place of residence the Uovving described real property for which a Homestead
(Property Tax Credit is hereby claimed: . I (We) owned El Are buying under contract
Have a beneficial interest in the entity that is Ii le for the property taxes on the property and that owns the
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
Co Township I T mg is ric (City, to n=
del Nurp er n 9 g scripti n�
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
C
ASSESSOR USE ONLY - TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
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)
0)
1991 Pay 1992
Lesser of 1/2 Homestead
Valuation or $1,500
19 —Pay 19—
Lesser of 112 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
Dale Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
Lesser of 112 Homestead
Valuation or $2,500
1990 Pay 1991
Lesser of 1/2 Homestead
Valuation or $2,000
1991 Pay 1992
Lesser of 1/2 Homestead
Valuation or $1,500
19 —Pay 19—
Lesser of 112 Homestead
Valuation or $1,500
Signature of Auditor
Date igne p