Homestead_Emge (2)ea '�'n ; CLAIM FOR HOMESTEAD PROPERTY TAX
;��= CREDIT/STANDARD DEDUCTION
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:�� State Form 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side 7or liling instructions.
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/ 7 !�f(�a _. _ certify that on the 7 st day of March, 19
� occupied o r pnnc:, a place of resid e the following described re roperty for which a Homestead Property Tax Credit is hereby daimed:
I (We) buyjng�under coniract .
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Have a be r�s3,��tFe entity that is liable tor ihe property taxes on the property and thai owns ihe property or is buying under a contract.
CONTRACTRECORDED ._
It buying on contracC Fee Simple owner's name . .
Recorder's oflite where contract is recorded ReCortl number Page
number
I Ihe residential 5trucNre or the
utitized m protluce inmme.
PROPERTY DESCRIPTION
/�c //'..i/oC / /.i
not ezceeding one (7) aue that immediatey surtounds that
e
is used ro produce income, describe Uie use and portion
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ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvemenis. (�)
Otherland (p)
Total land (line 1 plus line � (3)
Dwelling (4) � � .
Resideniial improvemen:s
Garage (5)
Other improvemenis (6)
Total improvements (line 4 through line 6� (7)
Total value (line 3 pLs line 7) (g)
1 hereby Certify lhe above is true. CArrect, and Signamre of Assessor Date signed
camplete. �
hg aaion - Signamre ot Auditor Date signed
79_Pay19_
Lesser of 1/2 Homestead
Valuation or 52.000
STANDARD DEDUCTION
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