Homestead_Miller (4)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
r 9:PTIFIr ATIr)N STATFMFNT
FORM Y AR
HC10
I (We) certify that on the 1 st day of March , 19
occupied ur principal place of residence the toll o described real property for which a Homestead
Pe)
roperty Tax Credit is hereby claimed: I (We) owned ❑ Are buying under contract
a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
El property
property or is buying it under a contract.
CONTRACT RECORDED
1991 Pay 1992
19 — Pay 19 —
Lesser of 1/2 Homestead
If buying on contract. Fee Simple Owner's Name
Recorder's office where contract is recorded
Record4NUrnbei: V3
r Wlage
PROPERTY DESCRIPTION ! yr ' n crs
n n /c i y
County �__ iTownship Taxing ist ct it wn H r7 lit
Legal
7 -1 It any portion of the residential, acr
structure or the land not exceeding one (1) e that im ediately 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
Township I County I Township
certify the above statements are true. correct and
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)
(1)
1989 Pay 1990
(2)
1991 Pay 1992
19 — Pay 19 —
Lesser of 1/2 Homestead
(3)
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
(4)
Valuation or $1,500
Valuation or $1,500
(5)
Dat9 Sig ed
(6)
i' -
(7)
(8)
1 hereby certify the above is true, Signature of Assesor
correct, and complete
Verifying Action - Signature of Auditor
Date Signed
TUate Signed
11 w.,m A mn ncnl lf`Tlr%M AI I nWANCF
J 1 I��vr+•
1989 Pay 1990
1990 Pay 1991
1991 Pay 1992
19 — Pay 19 —
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
Valuation or $2,000
Valuation or $1,500
Valuation or $1,500
Dat9 Sig ed
S1Qf1d1Nr@ gf - N ►Or
i' -