Homestead_Williams (16)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
,. CREDIT /STANDARD DEDUCTION HCO�� i..
State Form 5473 (R2 / 5 -92) y
INSTRUCTIONS: See reverse side for filing instructions.
FEB 1i19q
. :' ,•. -- q-- CERTIFICATIONSIATEMENT'"
".., .. a - .. .. ....._ .. - .. certify that,arliteVSt- daY-Marsh• .
I IWeI � � WCY..C� Flu a a �LtZ_xc� �
I (We) occupied as our principal place of �sidencelbe following described real property for which a Homestead Property Tau biedifis FieTeby'daimed
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.
- -t 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 d trict (city, town, township).
Parcel number
6�3c a -o
Legal description
If any portion of the residential structure or the land not exceeding one (I I 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 r
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant
L
�-'ss (number and street city, state, ZIP code) .
//-� s.
-
TRUE TAX
ASSESSE;j
HOMESTEAD
NON - RESIDENTIAL.
ASSESSOR USE ONLY
.VALUE
VALUE
VALUE
"VALUE
Land not exceeding t (one) acre immediately
- - -
surrounding residential improvements.
(t)
v
Other land
(2)
3„
Total land (line I plus line 7)
(3)
Dwelling
(4)
-
Residential improvements
Garage
(5)
-
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 jobs line 7)
(6)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE`" >„ -
I9_ Pay 19 _
Lesser of 1/2 Homestead 5
Valuation or $2,000
Signature of Au it r Date signed
�- -9