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d,�•.. CLAIM FOR HOMESTEAD PROPERTY TAX FORM A
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CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R2/1 -90) t
the foil g described real property for which a Homestead
Property 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 t ro�perty and that owns the
property or is buying it under a contract. y In
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If buying on contract. Fee Simple Owner's Name P 2 6 199
Recorder's office where contract is recorded 00n=lLWL&befh4 &ge
AUDITOR
A�/1�L ATV IICQl��I�TI/1A1
Township
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g Irk �I Legal Descriptiyl
If any'portion of the residential structure or the land not exceeding one6t) acre that irrlmediately suCrrounds that struc
lure is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
hereby certify the above statements are true. correct and
Address (Stree nu b r, city. state and ZIP ode) t
ASSESSOR USE ONLY TRUE TAX VALUE A SESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Otherland
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 112 Homestead
Valuation or $1,500
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(2)
Si at re o
(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 1/2 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
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Si at re o
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