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_ d.�e p•, CLAIM FOR HOMESTEAD PROPERTY TAX '� F
�;'�-, : CREDIT/STANDARD DEDUCTION Hc�o
;' State Form 5473 (R2/1-90) 8 .,.,'
�' '°�• � INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT ""'"""' '�' �"S
I(We) . . certify that on the 1 st day of March , 19 �
r; (We) occ i s o p cipal place of resi nce the following described real property for which a Homestead
Property Tax Credit is hereby.claimed � I(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.
If buying on contract.
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CONTRACT RECORDED
contract
PROPERTY DESCRIPTION
Tp�vAsJ,iip � _ ,� . . Taxing District
Record
town, township)
Par�el Num L I Descr on "
x�S-o��89-0� �-}- u� �.8-3-i� 3a-c.
If any portion of the residential structure 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.
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PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY , TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENiIAL
• � VALUE
Land not ezceeding 1(one) acre immediately '
surrounding residential improvemenis (�)
Otherland (2)
Total land - line (7) plus line (2) (3)
�-Residential improvements Dwelling - {4) � - - - - - � - - -
Garage (5)
Oiher improvemenis (6)
Total improvements - line (4) through line (6) (7)
To[al value - 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
7989 Pay 7990
Lesser of 1/2 Homestead
Valuation or $2,500
STANDARD DEDUCTION ALLOWANCE
1990 Pay 7 991
Lesser of 1/2 Homestead
Valuation or $2,000
U
7991 Pay 1992 19—Pay 19—
Lesser of 1/2 Homestead Lesser of 7/2 Homestead
Valuation or �1.500 Valuation or 57,500
Signature of Auditor /) � �/j / I /�
1/L1�u� � / !.(.�,,c.�/�� ,
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