Homestead_Gardner (3)d�•�, CLAIM FOR HOMESTEAD PROPERTY TAX
x'� �� ; CREDIT/STANDARD DEDUCTION
s .— 7 .
:� State Form 5473 (R2/1-90)
,' '°`• � WSTRUCTIONS: See reverse side for liling instructions.
CERTIFICATION STATEMENT
I (We) 17 (U'lL(1l(,1' l.�.k.JVI
1t�We) occupied as our principal place of
/�roperty Tax Credit is hereby claimed:
FORM
HC10
' o191g
�5 -w�
on the 1 st day of
the following described real property for which a Homestead
� I(We) owned ❑ Are buying under contract
� Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
property or is buying it under a contract. �G -�7 .3� -�QO — OQ/ 9/,f -Q�!
CONTRACT RECORDED
on coniract. Fee Simple Owner's Name
Recorder's office where contract is recorded
PROPERTY DESCRIPTION
County
Page
If any portion of the residential siructure or the land not exceeding one (7) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land noi ezceeding t(one) acre immediately
surrounding residential improvemeMS (�)
Other land (2)
Total land - line (7) plus line (2) (3)
Residential improvemen[s Dwelling (4)
Garage (5)
Oiher improvemenis (6)
Total improvements - line (4) through line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true. Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
1989 Pay 1990
Lesser of 1/2 Homestead
Valuation or $2,500
STANDARD DEDUCTION ALLOWANCE
1990 Pay 7991
Lesser of 1/2 Homestead
Valuation or $2.000
1991 Pay 1992 19—Pay 79—
Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or �1,500 Valuation or $1,500
Signature of Auditor Date
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