Homestead_PerryCLAIM FOR HOMESTEAD PROPERTY TAX
E CREDIT /STANDARD DEDUCTION
State Form 5473 (132 / 5 -92)
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INSTRUCTIONS: See reverse side for filing instructions.
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certify that on the 1st day of March, 19
occupied as our principal place of resiBence lbe following described real property fort v�lY'ch a Homestead Property Tax Credit is hereby claimed:
l(We)owned ❑ Are buying under contract C Q _ 1 _ 9 5
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
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
- PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township). _
Parcel number (
cs �e ^ L1'
Legal description
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
Weby certify the above statements are true, correct and complete.
Signature
imam
Addre um r a .d str dry. ate. P e) rr
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
I (1)
Valuation or S2,000
Signature of Auditor
Other land
(2)
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Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
"
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pfu line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
tying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
S
Valuation or S2,000
Signature of Auditor
Date signed
b-
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