Homestead_Bugherd' =R
ea °, CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
. State -Form 5473 (R215 -92)
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INSTRUCTIONS: See reverse side for filing instructions.
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I (We) occupied as our principal place of residence the follot i g described real property to hi
®I (We) owned ❑ Are buying under contract I 3
Have a beneficial interest in the entity that is liable for the property taxes on the roperty and
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r_ certify that on AUDITOrylarch, 19
lmestead Property Tax Credit is hereby claimed:
1
2wns the property or is buying . under a contract.
CONTRACT RECORDED
It buying on contract, Fee Simple owner's name - -
Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township).
Parcel number
Legaldescdption 5�n — ^ ,',Jl I1 D, ' 3 S0
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
I hereby certify the above statements are true, correct and complete.
Sign re QkJaimant
®-ess (number and street, city, state, ZIP code) 1 '
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
1146M-EWIEb�
VALUE
• NON - RESIDENTIAL ._
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pUs line 7)
(g)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
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