Homestead_Jonesa�. R•o
4g CLAIM FOR HOMESTEAD PROPERTY TAX
}' ��
CREDIT/STANDARD DEDUCTION
�: �� State Porm Sa73 (R2 / 5-92)
4u
INSTRUCTIONS: See �eve�se side lorliling instructions.
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(�qR p :; 1995
YEAR
U�
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n � �� wr��p1I1�1 (1R �
I(We) __ u.�t.�.�..d' �,Qf� . - . certay�th�t oh'th�e 1st day of March, 19
b(We) occupied as o � rinci I place of resid e the following described real property for which a Homesiead Property Tax Credit is hereby claimed:
�I (We) owned ❑ Are buying under coniract � . �� .. ,
LI Have a beneficial inierest in the entity ihat is liable for ihe property taxes on the property and Ihai owns ihe property or is buying under a contract.
. -- CONTRACTRECORDED - .
If buying on coniract, Fee Simple owner's name � .. � -
Recorder's oXice where contract is recorded Record number Page
Counry
Parcel number
rr� s_..,�40 _
If any portion of ihe residential siructure
of the property utilized to praduce incom
.�%� _ /7 /1 /—
Township
PROPERTY DESCRIPTION
� TaYirg tlistrict (cvry, fown, township)
Legal description
� � P� ���.�-3 �a -�%�o/��
or the land not ezceetling one (1 � acre hat immediatey surrounds ihat siructure is used to protluce income, describe ihe use and portion
- �3. 75�t -
� - PROPEFiTY OWNED BY CLAIMANT IN OTHER COUNTIES .
County Township County Township -
� hereby cenify ihe above siatemenis are irue, correct and complete. Signawre or ci " am
�ress (number alb street. ary, stafe. Z1P code)
O
ASSESSOR USE ONLY - THUE TAJC ASSESSED MOMESTEAD NON-RESIDENTIAL
. VALUE � VALUE VALUE VALUE
Land not ezceeding 7(one) acre immediatety
surrounding residential improvements. (�)
Otherland (p) ;
Total land (line 7 plus line 2� (3)
Dwelling (4)
Residential improvements
Garage (g) . .
Other improvements (6) �
Total improvemenis (line 4 through line � (7� I
Total value (line 3 p�s line � (g) �
I hereby certify ihe above is true, correct, and Signamre of Assessor Date signed
complete.
Verityirg aaion - Signature oi Auditor Date signed
� STANDARD DEDUCTION ALLOWANCE
79_Pay19_
Lesser ot 1/2 Homesiead
Valuation or 52.000 S
Signature of Autlimr Date signed