Homestead_Hayhurst�i"''°
°4 CLAIM FOR HOMESTEAD PROPERTY TAX
;��� CREDIT/STANDARD DEDUCTION
.�.;;� State Form Sa73 (R2 / 592)
�u�
INSTRUCTIONS: See reverse side lorliling instructions.
YEAR
�°��.;_ a�
0
H 0
!JAN 10 1994
�) � T�y ��'^' • KL/titaftify that on the 7 st day ot March, 79�
) occupied as ou ri pal place of residence th following described real property for whi a Homesiead Property Tax Credit is hereby claimed
❑ I (We) owned ❑ Are buying under coniract . � / _� �� - .
� tv
❑ Have a beneficial interest in the entiry ihat is liable for ihe property taxes on the pmperty and that owns the.property or is buying under a contract.
" � . CONTRACT RECORDED. �
It buying on coniract, Fee Simple owner's name ,
Recorder's oHice where contract is recortled Recortl number Page
County
PROPERTY DESCRIPTION �
. Taxing districi (ciry, town. fownship)
Parcel number Legal description
�05- G�910-oD �+s N� a�-3- �� �a.e� �
I1 any portion of che residential strucmre or ihe land not exceedirg one (1 � acre that immediatety surmunds that structure is usetl to protluce income, describe Ihe use and portion
of the property utilized ro produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES -
County �_ Township , Counry . ivwpWip_ �
� 5 a� e f �mani
�eby certify the above siatements are true, correct and complete.
A r (numberandsrreef,ciry,slate,ZlPmde)
,e �2 Bo / 7 a�c-,� s' l(� �' �f 7�� s'
ASSESSOR USE ONLY TRUE TAX . �� ASSESSED HOMESTEAD NON•RESIDENTIAL �
: VALUE VALUE� VALUE VALUE
Land not exceeding 1(one) acre immediately �
surrounding residential improvemenis. (�� �
Oiherland (2)
Total land (line 7 plus line � (3)
. Dwelling (4)
Residential improvements
Garage (5) I
Other improvements (6)
Total improvements (line 4 (hrough lina � (7)
Total value (line 3 pVs line � (g)
I hereby certify ihe above i5 ime. Correci, and SignaNre ot Assessor Dare signed
complete.
�ng ac6on - Sgnature of Audiror Dare signed
19_Pay19_
�ser of 7/2 Homestead
STANDARD DEDUCTION
3
SignamreofAuAiror � A� I � A� IDare'
1