Homestead_Estep (2),..�;.:
e,� °g CLAIM FOR HOMESTEAD PROPERTY TAX
}���',; CREDIT/STANDARD DEDUCTION
�:�• State Fortn 5473 (R2 / 5-92)
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ied .
INSTRUCTIONS: See reveise side lor liling instructions.
_ � �, - - � CERTIFICATION STATEMENT
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;��T = 7 1993
I IVJ�J��j1W� •� �_ � � certify that on ifie 9y d� {� 079�;
MU� I V�
) occupied as our principal place of residenc e following described eal property for which a Homesiead Property Tau Credit is hereby daimed:
,_, I(We) owned ❑ Are buying under contract
❑ Have a beneticial imerest in the entiry that is liable for the property taxes on the property and ihai owns the pmperty or is buying under a contract.
CONTRACT RECORDED
� It buyirg on ContraCL Fee Simple owner's name � . ' , ' - .
Recorder's otlice where coniract is recorded Recortl number Page
Counry
Parcel number I Legal de:
�s-c�3�a�
If any portion ot the residential stmcture or the land not
ol the propeny utilized to produce income.
Couniy
ra�r_c
a -Oo 3. 7
PROPERTY
Township
PROPERTY DESCRIPTION
Taxirg district 'ry, fown, township)
a�l- - 1 �i. .
�- p��. 3�-a -11 �,ofl �+c. -
(7) acre ihat immediatety surrountls ihat swcture is used to produce income, describe the use and portion
y certify the above statements are true, correct and complete.
;(numberandstreeca state,ZlPcode)
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BV CLAIMANT IN
Township
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land noi exceeding 1(one) acre immediate�y
surrounding residentiai improvements. (�)
Oiherland (Z)
Total land (line 7 plus line Z� (3) I
' Dwelling (4)
Resideniial improvements
Garage (5)
Other improvements (6)
Total improvements (line 4 thiough line 6) (7)
Total value (line 3 p�s line � (g)
I hereby certify the above is Irue. Correci, and Signature ot Assessor Date signetl .
complete.
I�yinq attion - Signaiure of Audimr I Date signed
19_Pay19_
Lesser of 1/2 Homestead
Valuation or 52.000 '
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STANDARD DEDUCTION ALLOWANCE
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Da:e signed
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