Homestead_Keller (2).�•_� . CLAIM FOR HOMESTEAD PROPERTY =TAX -� �q vEaR
al�: % Y. . . - - - FORM_
�F'�` y: CREDIT/STANDARD DEDUCTION C�-03 �Q� c�
�� State Form 5473 (R2/1-90) � - �.,� � ��
'°�: INSTRUCTIONS: See reverse side lor liling instructions. � /
CERTIFICATION STATEMENT � _ . _:. . _
�w; , --� - C�'
1(We) a.� certify that on the�.1/s�,t, d�ay of arch , 19�
�; (We) occupied as our principal place of residence the fol�owing described real prop�rt"��io�a L�omestead
Property Tax Credit is hereby claimed: C�f"(We) owned ❑ Are buying under contract
� Have a beneficial interest in the entity that is liable for the prop�erty taxes on the property and that owns the
property orisbuqing it under a contract. . .
If buying on contract. Fee Simple
Recorder's office where contract
CONTRACT RECOROED
Name
PROPERTY DESCRIPTION
, - . Taxing Dis,tJ{S
town, township)
, � ��
Parcel Number Legal Descripii n � �
Oa - 8359�'�O m- .d.�.
If any portion of the residential structure or the land not ceeding 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.
. � � .- _ ,
1!�-�lVV !✓J.o//d�vr/—/
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Township . County -
hereby certify the above siatemenis are true.
Address (Sireet. number, city, state
,. _
ASSESSOR USE ONLY
TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
NON-RESIDENTIAL
VALUE
�
Land not exceeding 1(one) acre immediately ' '
surrounding residential improvements (� )
Otherland (2)
Total land - line (1) plus line (2) (3)
� Residentialimprovemenis � �' 'Oweiling- � (4) - -- - -- - � -
Garage (5)
Oiher improvemenis � (6) -
Total improvements - line (4) through line (6) (7)
7otal value - line (3) plus line (7) (8)
I hereby certify the above is irue, Signature of Assesor Date Signed
correcl, and complete
Verifying Action - Signature of Auditor `� Date Signed
/�
1989 Pay 1990
Lesser of 7/2 Homestead
Valuation or $2,500
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1997
Lesser of 1/2 Homestead
Valuation or �2.000
7991 Pay 1992 19—Pay 19—
lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or 51,500 Valuation or $1,500
Signature of Auditor %� `� Date Signed
l 1 n..�-2 p. �1 ' L�ne wa% 3-13- 4 I