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eE CLAIM FOR HOMESTEAD PROPERTY TAX FORM
e CREDIT /STANDARD DEDUCTION HCJO
.`` State Form 5473 (R2 / 5 -92) F
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INSTRUCTIONS: See reverse side for tiling instructions. - .
YEAR
'e) 6 f t a We.4 March, 19
`j occupied as our principal place of residence the following descri Cal grope y for which a Homesiea wom t is hereby claimed:
1
!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 under a contract.
CONTRACT RECORDED `
It buying on contract, Fee Simple owners name
Recorder's office where contract is recorded Record number Page
' PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION
County
Township -
Taxing district (city, town, township)
Parcel n tuber
Legal des ,piton
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
Signature of Auditor
Other land
(2)
' PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
eby certify lthe above statements are true, correct and Complete.
�ess
i9n •ure of Claimant
rand street, city. state, ZIP code)
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
Signature of Auditor
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plis line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
"ng anion - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
5
Valuation or $2,000
Signature of Auditor
Date signed
t\
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