Homestead_Emge�"` �'"" - CLAIM FOR HOMESTEAD PROPERTY TAX
; � CREDIT/STANDARD DEDUCTION
.
�� State Fortn 5473 (R2 / 592)
•�e' �
INSTRUCTIONS: Sc�u�qr6e side lo� �ling instructions.
I (We) �� � ktd e�fY:i
I(We) occupied a our principal place of residence the foll ing described real properry for w i h a HOmestead Prop
❑ I(We)owned ❑ Are buying under coniract R 1 2
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that own�he prope
CONTRACT RECORDED �, . , ��.��YS t
on contract, Fee Simple owneYS name
��
- o �a�s �
ihe residential sirucNre or t
ized to D��uce inmme.
�� _ / Q /S-
PROPERTY DESCRIPTION
�
. �.. -
— UU/• OS%� �Ud/ �
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
certify the above statemenis are true, correct and complete.
iumber arM sf ,�t. city, sfate, ZIP code� ,/ � ��
ASSESSOR USE ONLY
Land not ezceeding 1(oneJ acre immediately
surtounding residential improvements.
Oiher land
Tofal land (line 7 plus line 2)
Dwelling
Residential improvements
Garage
Other improvemenis
Total improvemenis (line 4 through line 6J
Total value (line 3 plus line 7J
I hereby certify the above is true, correct, and
complete.
VeriMna ac6m - Sionature of Auditor
19_ Pay 19 _
Lesser of 1/2 Homestead
�luation or $2,000
TRUE TAX
VALUE
1�)
(2)
(3)
(4)
(5)
(6)
l�)
(8)
STANDARD DEDUCTION ALLOWANCE
5
FORM YEAR
HC70
bd tti�}�'t day of March, 19_
y Tax Credit is hereby claimed:
000
�or is buying u/per a coniract.
HOMESTEAD
VALUE
Ne use and portion of
NON-RESIDENTIAL
VALUE
signed
. �.
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