Homestead_Jochim (7)4� ��� s CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
3� � CREDIT/STANDARD DEDUCTION C� .
�/� State Porm 5473 (R2 / SA2) �I-,� � __- _ � � �n� �4
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MSTRUCTIONS: See rev rse side for7iling instructions. �
b�a�.� rn�t /,e , �o„/ � 3-�- 9 � �
�.-�,. , , � -� ���� . � �. —�ERTIFICATION STATEt�NT� '� _ 6 _,- ;�� q11DITOR �
� i� r �i� y
i� e) // l, certify-ihai on the 7st day of March, 79
� o upied as our principal place of residence the following describe al property.for which a Homestead Property Tax Credil is hereby claimed:
I( ) owned ❑ Are buying under coniract
❑ Have a beneticial interest in the entity ihat is liable for the property tazes on the property and thai owns the property or is buying under a contract.
` � ` � � � CONTRACT RECORDED'>. � ' ' -" ` � � �
� -r., . .. , . . . . . . _ ,.
If buying on contract, Fee Simple owners name ,
Recorder s ottice where contract is recorded - Recortl number Page
Counry
Parcel num6er
C�o 5-�
If any portion of
of the property i
� `�°� � -� PROPERTY DESCRIPTION �
Township � Ta �ing dislricl (ciry,
L/(o' w I 1 ► v w ,�, l– c� —
itlential strucwre or the lantl not exceeding one (1 � acre that immetliatety surmunds Ihat sn
to produce income.
�
rownship) �
is used to protluce income, tlescribe ihe use and portion
� � - ' PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES - � � -
County Township County Township
�eby certify the above siatements are true, correct and complete. � awre of aaiman�
Adtlress (numberandstreef, city, sfa(e, ZlPwde)
� ASSESSOR USE ONLY � _- TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAC,
. � � �,VALUE VALUE. � ��VALUE. � VALUE ..
Land not exceeding 7(one) acre immediately - �.
surrounding resideniial improvemenis. (�) . -'
Otherland (2) - �
Total land (line 7 plus line � (3) "
Dwelling (4) ' , . . � - � �
Residential improvements �
Garage (5) � � � _ � .
Other improvements (6) . � .
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � (g)
I hereby certify ihe above is true, correct, and Signamre of Assessor Date signed
complete. � �
;��ing action - Signature ot Autlitor Date signed
19_Pay19_
Lesser of 1/2 Homestead
Valuation or 52.000
-� �STANDARD�DEDUCTIONALIOWANCE
S
of Autlitor � Date signed -