Homestead_Goodman (3)�� CLAIM FOR HOMESTEAD PROPERTY TAX
Y� '� CREDIT/STANDARD DEDUCTION
�, State Fartn 5473 (R2 / 5-92)
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INSTRUCTIDNS: See reverse side lor liling inshuctions.
FORM
HC10
YEAR
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�Ne) O � certity that on the 1 st day of �March. 79_
Je) occupied as our principal p�ace of residence ihe following described real property tor which a Homestead Pioperty Taz`YCretlit'fs��daimed:
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I ❑ I (We) owned ❑ Are buying under contrect '{ � � %� ^ '.j
❑ Have a beneticial interesi in the entity that is liable for the property taxes on the property and that owns the prop9pn,pr ��yiq�yn�der a contract.
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Ii Wyirg om m�irad, Fee Simple owner's name
Recorder's oHice where contracl is recOrded
Parcel numDer LegalOe:
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If any ponion of ihe residential stmcture or [he IaM not
of the properry utilized to produce income.
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Record number
PROPERTY-0ESCRIPTION � � �
Taxing tlistricl ( wr�hip)
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Page
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one (1 � aae ihat immediately surrountls Ihat siruciure is used to produce income, descriDe ihe use arM portion
I �/- ia-.� -��- �s,3. �3.5 =002./ I
�ASSESSOR USE ONLY � TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAh.
� VALUE VALUE VALUE VALUE ..
Land not exceeding 7(one) acre immediately . . -�
surroundingresideniialimprovements. (�) 'Q� �
Oiher land (2� � 3,. `� � � �
Total land Qine 7 plus line Z� (3)
Dwelling (4) � - . °.
Residential improvements . . :
Garage (5) ' � .
Other improvements (6) �
Total improvements (line 4 through line 6j (7) I
Total value (line 3 pUs line 7� (g)
I hereby Certity Ihe above is irue, torrect. and Sgnamre of Assessor Date signed
complete.
��yrtg adion - SgnaNre of Auditor . Date signed
19_Pay19_
Lesser of 1/2 HomeStead
Valuation or 52.000
S
I Uate spnea
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