Homestead_Fetcher (3)e�%-�� � CLAIM FOR HOMESTEAD PROPERTY TAX
_��� CREDIT/STANDARD DEDUCTION
�� State Form 5473 (R2 / S92)
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INSTRUCTIONS: See reve�se side 7or liling insiructions.
E� -� ` � - � �ERTIFICATI
i. ? � �� ���
t
OCT 1 g 199�
I(We) occupied as our principal place ol residence the fo0owing described real property for which a Homesiead PropeR�'I`ailCreiii�'s'HeieBj� claimed
❑ I(We) owned ❑ Are buying under contract
❑�Have a beneticial interest in the entity that is liable for the property taxes on the property and that owns the property�or is buying under a contraci.
� � - - � - . CONTRACT RECORDED � � � . - - .
It huying on contrac6 Fee Simple owner's name -
Recordefs oflice where contract is recortled Record number Page
County
Parcel number
�t�
If any portion of
of the pmperty i
to
� - PROPERTY DESCRIPTION
Township Taxi ' I(City. t n, town5hip)
Legal description
'
a land not exceeding one (t) acre ihat immediatey surrounds that sirucNre is usetl to produce
�r�.r.oi��
�
describe the use and portion
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES ' -
�ty Township Couniy Townstup
I hereby certify ihe above statements are true, correct and compiete. Si9namre o� ciaimant
- �
Atldress (number and slreel. dry. state. ZIP code) '
�=3 w r�c — 7(aloa
ASSESSOR USE ONLY
Land not ezceeding 7(one) acre immedietely
surtounding residential improvements.
Other land �
Totai land (line 7 plus line �
Dwelling
Residential improvements
Garage
Other improvements
Total improvemenis (line 4 fhrough.line �
Total vatue (line 3 p�s line 7�
�by certify the above is true, correct. and
lete.
Ventying aaion - Signamre ot Auditor
TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
(�)
(z1
(3)
(4)
(5)
(6)
(�)
18)
Signature ofASSessor
IDare signetl
Date sgne�