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����•v CLAIM FOR HOMESTEAD PROPERTY TAX M �YEAR
=r"A� ' CREDIT/STANDARD DEDUCTION �I�i �4 I C� I I
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��., ,��' State Form 5473 (R2/1-90) ' `=!—'
_ INSTRUCTIONS: See reverse side for filing instructions. SEP 1 9 1991 ,f�
CERTIFICATION STATEMENT � � � � -
I(We �-1 •°� �� �� certify that on the 1 st d��2iCh , 19 �
'I (We) occupied a our principal place of residence the followjng described real property for which a Homestead
�—, /
Property Tax Credit is fiereby claimed: ,��' I(We) owned ,. ❑ Are buying under contract
� Have a beneficial interest in the entity that is liable for the property tazes on the property and that owns the
property or is buying it under a contract.
CONTRACT.RECORDED
on contracL Fee Simple Owner's Name
Recorder's office where coniraci is
County
PROPERTY DESCRIPTION
, Taxing ¢iSttjct (Cjty, town, township)
raicei rvuuwei �cym vca���Nurn�
�5 -o353`j ;� N� 33-a-ia aa.a�a-�
If any portion of the residential structure or the land not exceeding one (1) acre that immediatety surrounds that struo-
ture is used to produce income describe the use and portion of the property utilized to produce income.
�?L- /D - 33 -a.?ao- aa 3. 5.39- ooz./
PROPERTY. OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY � TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
" • ' � VAWE
Land not ezceeding 1(one) acre immediately
surrounding residential improvements (�)
Other land (2)
Total land - line (7 ) plus line (2) (3)
Residential improvemems Dwelling - (4) - - - - - � -
Garage (5)
Other improvements (6)
Total improvemenis - line (4) ihrough line (6) (7)
To�al value - line (3) plus line (7) (S) �
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
1989 Pay 1990
Lesser of 1/2 Homestead
Valuation or $2,500
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991
Lesser of 1/2 Homestead
Valuation or $2.000
1991 Pay 1992 19 — Pay 19 —
Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or �1,500 Valuation or $1,500
Signature of Auditor y `� �� Date Signed
1 m.,..2 �.� L�-�-�-� q' a0'91