Homestead_Begeman... =•4 CLAIM FOR HOMESTEAD PROPERTY TAX
e CREDIT /STANDARD DEDUCTION
.a � •. y
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
v"" r u 1ve nvn . r M, runu1 r
IF
I (We) occupied as our principal place of residence the
FORM YEAR
HC10 O
da 5; "o°o719
entity that on the 1 st day of March , 19 0
described real property for which a Homestead
Property Tax Credit is hereby claimed: 4=-1I (We) owned Q 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
EJ property or is buying it under a contract.
x-400.079 - -eW
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name
Recorder's office where contract is recorded
Record Number r
Page
PROPERTY DESCRIPTION
County
Township(Y]
1991 Pay 1992
Lesser of 112 Homestead
Valuation or $1.500
Taxi ict ( it ). town, township)
Parcel Number
00 - 0ol
Lea scn
, • zf Q N 5- 3 -1 �•oo R �—
If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
11-70 IC 2170 le
/
1kA�tt�bt✓Yt 20o A/ /.3Go 41-e
1
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
�ounty
j
Township
ounty
wnship
I hereby certify the above statements are true. correct and
Sig r -
complete.
Address (Street. number, city, state and ZIP code)
AUDITOR
` ASSESSOR�USE ONLY - TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
Land not exceeding I (one) acre immediately
surrounding residential improvements
Otherland
Total land - line (1) plus line (2)
.Residential improvements - Dwelling
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
-
(1)
1991 Pay 1992
Lesser of 112 Homestead
Valuation or $1.500
19 —Pay 19—
Lesser of 112 Homestead
Valuation or $1,500
(2)
Signature of Audi Date Signer
_ _ _ A r
(3)
(4)
(5)
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
'M�`
Date Signed
V_ STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
Lesser of 112 Homestead
Valuation or $2,500
1990 Pay 1991
Lesser of 112 Homestead
Valuation or $2,000
1991 Pay 1992
Lesser of 112 Homestead
Valuation or $1.500
19 —Pay 19—
Lesser of 112 Homestead
Valuation or $1,500
Signature of Audi Date Signer
_ _ _ A r