Homestead_Klusmeier (3)� :r..F
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn Sa73 (R2 / S92)
contract
❑ Have a beneficial interest in the entity that is liable for the property tanes on the property and tha ns the b� n a contract.
er, ± OUt Y AUDITOR
CONTRACT RECORDED
If buyinq on cont2cl, Fee Simple owners name
Fecorders oflice where conVact is recortletl � Record number Page
PROPERTY DESCRIPTION
Coun Township � Ta<ing dist' o. mwnshi )
0 o yII�berO/� Legal description ! �
5- 78-�
If any ponion ot the residential strucNre or the land not exceeding on ) acre thai immediatey surrounds that sWCture is usetl to produce income, scriCe ��e use antl portion of
the property ulil¢ed to produce inwme.
�G- -���� - D�/. �7� - D�-/ ..
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township County Township
Si of claimant
�reby certi(y the above statements are true, correct and complete. �
Ad ess nom r and streel, ciry, state, ZIP cotle) ^ � �
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ASSESSOR USE ONLY . TRUETAX ASSESSED HOMESTEAD NON•RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not ezceeding 1(one) acre immediately (��
surrounding residential improvements.
Other fand (2) -
To[al land (line 7 plus line 2) . (3)
Dwelling (4)
Residential improvements
Garage (5)
Other improvements � (6)
Total improvements Qine 4 through line 6) (7)
ToWI value (line 3 plus line 7) (8)
I hereby Certify Ihe abOVe is tNe, Cofrect, and SignaWre of ASSemr - Date signed
complete.
Verifying action - SgnaNre of AWitor Date signetl
� STANDARD DEDUCTION ALLOWANCE
19_ Pay 79 _
Lesser o( 7/2 Homestead c� %
ValuaY n or S2,000
SignaWr tlitor Daresign � T �
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