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CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
E� CREDIT /STANDARD DEDUCTION D
' State Form 5473 (R2/5-92) Eal
es
INSTRUCTIONS: See reverse side for filing instructions. SEP 2 3 199 fi
le) Certify that on the 7961 p R, 1 _
)occupied as our principa lace of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
l(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.
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 TT T
U - C) CJ
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 of claimant
Valuation or $2.000
V fin
Address (number and street. city, state, ZIP code)
3Li S. 3 on OAKI Fln u . Lt
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
,. VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2.000
Signature of Auditor
Other land
(2)
-
Total land (line 1 plus line 2)
(3)
I
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plis line 7) -
(g)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
aing action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE -
19 _Pay 19_
Lesser of 112 Homestead
$
Valuation or $2.000
Signature of Auditor
Date signetl
A