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Home My WebLink AboutHomestead_Feldmeier (17)dE 44 CLAIM FOR HOMESTEAD PROPERTY TAX i CREDITISTANDARD DEDUCTION State Form 5473 (R2 15-92) reu INSTRUCTIONS: See reverse side for filing instructions. YEAR Hit in,,AA ^ c MAY - 9199 I IWe) —i.0 `-1 �,JLJC.(� ��2J�tL�i certify that on the 1st day of March, 19_ 03) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed: [J 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. CONTRACT RECORDED ' It buying on contract, Fee Simple owner's name _ Recorder's office whe a contract is recorded Record number Page ' PROPERTY DESCRIPTION County Township Township Taxing district (city, town, township) _ Parcel number © - oolzt, aoo Legal description ._71 VALUE If any portion of the residential structure or the land not exceeding one (1) acre tQ75mediately of the property utilized to produce income. ur unds that stu. ture is used to i5roduce income, describe the use and portion PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County Township County Township ®-eby certify the above statements are true, correct and complete. Si tune of claimant Address (number and street, dry, state. ZIP code) z7 I 14ARP -Is � ST , 0AV.A06 el,y A), 41(P(co r ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON - RESIDENTIAL VALUE VALUE VALUE VALUE Land not exceeding I (one) acre immediately surrounding residential improvements. (1) Other land (2) Total land (line 1 plus line 2) (3) Dwelling (4) Residential improvements , Garage (5) Other improvements (6) Total improvements (line 4 through line 6) (7) Total value (line 3 plus 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 19 _Pay 19_ Lesser of 1/2 Homestead Valuation or $2,000 S 1 uare s ne Slgnaturti Auditor J/�w0 Q — 6