Homestead_Cleme i CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
� State Form 5473 (R2/5-92)
INSTRUCTIONS: See reverse side for filing instructions.
JUN 4 1993
certify that on th0ltstf- ddTTA71
ROW '19 �-
occupied Wour pr ipal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
®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
If buying on contract. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION -
County
Township
Taxing district (city town, township)
Parcel number
-O D3 -
Legal description ^ 3_3 —I ^ cal+ 2,00l9-c_
°S) Gcl
If any portion of the residential structure or the land not exceeding one (1) acre that immediatety surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
dress
..udress (number and street city. state, ZIP code)
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES ,
County
Township
County
Township
certify the above statements are true, correct and complete.
Signat re of claimant
/�— /l�fli"^
dress
..udress (number and street city. state, ZIP code)
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
Signature of Auditor
Other land
(2)
Total land (line 1 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 plus line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
®tying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
S
Valuation or $2,000
Signature of Auditor
Date signed