Homestead_Halld�•R, CLAIM FOR HOMESTEAD PROPERTY TAX
�"" � ' CREDIT/STANDARD DEDUCTION
:.--;::
:� State Form 5473 (R2/1-90)
�'°'° ` INSTRUCTIONS: See reverse side for filing instructions.
I (We)
CATION STATEMENT
FORM YEAR
HC10 �
o�,s -�3a�
certify that on the 1 st day of March , 19 �
'(We) occupied as our principal place of residence the following described real property for which a Homestead
!'roperty Tax Credit is hereby claimed: LIYi (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.
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name
Recorder's office where contract is recorded Record Number Page
PROPERTY DESCRIPTION
County
town,
Parcel Number Legal De ri tion
� 30 � a-oo �� �. s�.� a�- a- i� c�. �� Us
If any po� n of the resideniial siructure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
—""°°�£PP�Y OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
�and not ezceeding t(one) acre immediately
surrounding residential improvements (�)
Otherland (2)
Total land - line (7) plus line (2) (3)
Residential improvements Dwelling (4)
Garage (5)
Oiher improvements (6)
Total improvements - line (4) through line (6) (7)
Total va�ue - 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
Signature of Auditor
STANDARD DEDUCTION ALLOWANCE
1990 Pay 7991 1991 Pay 1992 19—Pay 79—
Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or $2,000 Valuation or �7,500 Valuation or $1,500
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