Homestead_Johnson (10),.•,='a
�>" g CLAIM FOR HOMESTEAD PROPERTY TAX
;���= CREDIT/STANDARD DEDUCTION '
.�.;;� State Form Sa73 (R2 / 5-92)
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INSTRUCTIONS: See �everse side lor tiling instructions.
- � " FORM YEAR
HC70 �
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���i VIW � l n[cee — .. ...... �
� certify that on the 7 st day of Mareh, 19
�) occupied as our principal place of residence the tollowing cr d�real property for which a Homesiead Pro�'e��Cr�it is �J�qrgby claimed:
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❑ I(We) owned ❑ Arebuying under contracl AUDITOR�
❑ Have a beneticial interest in the entiry that is liable for the property taxes on the property and that owns the property or is buying under a contract.
CONTRACT RECORDED ,
If buying on contract, Fee Simple owner's name . � . . .. . �
Recortler's oHice where contract is recortletl Recortl numher Page
Counry
' PROPERTY DESCHIPTION
Township . Tazinq dstrict (ciry, fown, townsM1rp)
Parcel number Legal tlescription
r�s =r�3�3�-� P�_N.� �-�- a �a 1-�s�i�,
It any portion of the residential struaure or the land not exceeding one (71 aae that immediatey wrrounds that siructure is used to produce income, tlescnbe Ne use antl portion
of fhe property utilized to produce income.
- /D - 3'f �i.Y - DD3. 737- oo.t./
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES �
County Township County Township
:by certify the above siatements are [rue, correct and complete. Signawre ot daimant
Atldress (number antl sfreet, ciry, staie, ZlPwde)
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE ,
Land noi exceeding 1(one) acre immediately
surrounding residential improvements. (�)
Otherland (2)
Total land (line 1 plus line Z� 3 �
O
Dwelling (4)
Resideniial improvements
" Gara9e (5) .
Other improvements (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � (g�
I hereby tertify Ihe above is true, Corrett, and Signamre ot Assessor I Date signed
complete.
ing action - Si9namre of Auditor Date signed
J L
STANDAHD DEDUCTION ALLOWANCE
19_Pay19_
Lesser of 1/2 Homesiead
Valuation or 52.000 S
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