Homestead_Hoskinse� ^ a CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
y State Form 5473 (R2 15-92)
eau
INSTRUCTIONS: See reverse side for filing instructions.
.Ne) ! kj yt, C /�.T7" certify that on the 1st day of March, 19
eyoccupi as our principal lace 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 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
PROPERTY DESCRIPTION
County
Township
Taxing district (cit ; tow, 'towns ip)
4
I ber
NON-RESIDENTIAL
VALUE -
Ir
Legal description
If any neon of the reside ual structure or the land not exceeding one (1) acre that immediate urrounds that shuclund is used to pro (We income, describe the use and portion
of the property utilized to produce income.
BY CLAIMANT IN OTHER COUNTIES
certify the above statements are true, correct and complete.
Address (number and meet, 64, state, ZIP
STANDARD DEDUCTIC
59 P _
Lesser of 1/2 2 Homestead S
Vawation or $2,000
01 Auditor
5
ASSESSOR USE ONLY
TRUETAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON-RESIDENTIAL
VALUE -
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
"
Otherland
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(S)
Total improvements (line 4 through line b)
(7)
,
Total value (line 3 plus line 7)
(g)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
errying action - Signature of Auditor
Date signed
STANDARD DEDUCTIC
59 P _
Lesser of 1/2 2 Homestead S
Vawation or $2,000
01 Auditor
5