Homestead_Edwards..�^•� _
a�/ g CLAIM FOR HOMESTEAD PROPERTY TAX
l;p ��;; CREDIT/STANDARD DEDUCTION . '
,�Fe�a.;.• State Porm 5473 (R2 / 5-92)
��
�ai•
INSTRUCTIONS: See �everse side tor liling instructions.
FORM yE R
HC10
1(We) � U� W(.G�-6��. certify 1�� tF� lst�gf March, 79_
1(We) oc u" �as our principal place of residence ihe following described real property for.which a Homestead �roperty Tax Credit is hereby daimed:
We) owned ❑ Are buying under contraci . �/a . .. !L s
' � � WYI�nRJ A7
� Have a beneficial interest in the eniiry that is liable for the property taxes on the property and that owns the prop���'It� nder a contract.
' CONTRACT RECORDED � � �
If buying on contract, Fee Simple owner's name , - _ . , . , _ _ � , •
RecOrtler's oftice where contract is recorded Record number Page
Counry
R
Counry
PROPERTY DESCRIPTION
' . ' Township Tazing district (city,
�r � Legal description
ot ihe residential simcture or the land no� exceeding one (11 acre ihat
y utilized to produce income.
_ 3 (� �--� ��� �a .8��
surmunds Ihat swcture is used m produce income, deuribe the use and portion
'/D �✓(O �iJIDO—Gt'J��JC/S� Do��
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES�
Township Couniy
I hereby certify the above statements are true, wrrect and complete.
�reu (number and s(reeC 6ry, state, ZIP cotle) ,
ASSESSOR USE ONLY
Land noi exceeding 7(one) acre immediately
surrounding residentlai improvements.
Oiher land
Total land (line 1 plus line 2� �
Dwelling
Residential improvements
Garage
Other improvements
Total improvements (line 4 through line �
Total value (line 3 p�s line 7�
I hereby certify the above is true, correct, and
complete.
Veritying action - Signature ot Autlitor
TRUETAX I, ASSESSED
.VALUE VALUE
(�)
i2)
(3)
(4)
(5)
(6)
1�)
(8)
SignaNre of Asseswr
�HOMESTEAD I NON-RESIDENTIAL..
VALUE VALUE _
Date signed
Date signed