Homestead_Dike (8)a�. R,,,
i,��'' °„ CLAIM FOR HOMESTEAD PROPERTY TAX FOpM VEAR
: CREDIT/STANDARD DEDUCTION � , riCio �
.�, ��,,��� State Form 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side loi /iling instructions. -
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� � � CERTIFICATIONSTATEMENT� - " '
�;) � certify ihat on ihe tst day of March, 19_
i(We) occupied as our principal place of residence ihe following described real property tor which a Homestead Pmperty Ta�c Credit is hereby daimed:
❑ I (We) owned ❑ Are buying under contraci � , . � ,
❑ Have a beneficial interest in the entity thai is liable for the propeny taxes on ihe property and thai owns ihe property or is buying under a mntract.
�� CONTRACTRECORDED � �
I If buying on contract, Fee Simple owner's n me - . .
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Recorder's oftice where contract is recorded Recortl number Page
' PROPERTY DESCRIPTION -
County �Township � . Taaing tlistrict (city, fown, fownshrp) ,
t-�r- � � i� � X �-2� - � - ��— .1�
:itlential stmaure or the land not exceeding one �7) acre that immediatety surmunds that strucNre is usetl to protluce income, tlescnbe the use and ponion
ro produce income. -
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_i��9_/vo-oQ��3G/-
PROPERTV OWNED BY CLAIMANT IN OTHER COUNTIES
County Tawnship Counry Township
I hereby certify the above statements are irue, correci and complete. Sgna� ot ciaiman _ �
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Address (number and slreeC ciry. state, ZIP code)
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL -
VALUE VALUE. VALUE VALUE
Land not exceeding 1(one) acre immediately � �
surrounding residential improvements. (�)
Otherland (p)
Total land (line 7 plus line Z� (3)
Dwelling (4) � �
Residential improvemenis
Garage (5)
Other improvements (6)
Total improvemenis (line 4 through line � (7)
Total value (line 3 p�s line � (g)
I hereby Gehi�y Ihe above i5 irue, CorreCt, and Signature of Assessor � Dare signed
�-�nplete.
ing ac�ion - Signa:ure o� Auditor Date signed
- a- �o- s
OEOUGTION ALLUWANGt
19_Pay19_ (
lesser of 1/2 Homestead
Valuation or 52.000 S