Homestead_NalleyPpp� dam; , CLAIM FOR HOMESTEAD PROPERTY TAX
5 CREDIT /STANDARD DEDUCTION
State Form 5473 (R2/1 -90)
° ° INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
FORM YEAR
HC10
that on the 1 st day of March , 19
�(We) occupiqgas our principal place of residence the folio in "escribed real property for which a Homestead
roperty 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 it under a contract. MITT '97\
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name APR Z 1990
Recorder's office where contract is recorded R rgord Numlr r Page
PROPFRTY nFSCRIPTION
Township
24 to v /J 7-r/t- r v �
If any portion of the residential structure or the land not exceeding o (1) acre that imm lately 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 County Township
certify the above statements are true. correct and Si ature
1•
(Street. number. city, state and ZIP code)
/o Wilt 104rrl. d+AAJA6J s+'rb.0 ii+. yl«e
ASSESSOR USE ONLY / TRUE TAX VALUE ASSESSED 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 1/2 Homestead
Valuation or $1,500
(2)
Sig u 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
Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
'-esser of 112 Homestead
Valuation or $2,500
1990 Pay 1991
Lesser of 112 Homestead
Valuation or $2,000
1991 Pay 1992
Lesser of 1/2 Homestead
Valuation or $1,500
19 — Pay 19-
Lesser of 1/2 Homestead
Valuation or $1,500
Sig u of Auditor
�aj2. Si9ngd:; nU
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