Homestead_Pingd�� �F, CLAIM FOR HOMESTEAD PROPERTY TAX�, v�
_'"`` y ° CREDIT/STANDARD DEDUCTION f •��l,rp
� State Form 5473 (R2/1-90) - U �
,' '°° �� INSTRUCTIONS: See reverse side.(or liling instructions.
CERTIFICATION STATEMENT
�I (We) �F'�v �/"�_�—c�Nw-c-w � v�
I(We) occupied as our principal place of residence'
Property Tax Credit is hereby claimed: �
FORM. YEAR
Hc,o - �G�q
� s- °i yo 1
certify that on the fst day of March , 19
I�ing described real property for which a Homestead
(We) owned _❑ Are buying under contract
� Have a beneficial interest in the entity thai is liable for the property taxes on the property and that owns the
property or is buying it undera contract.
If buying on contract. Fee Simple
Recorder's office where contract
CONTRACT RECORDED
Name " .
PROPERTY DESCRIPTION -
Taxing District (City, town; township).
�.r...nn__ . .. ..
Parcel Number Leg s i .
�o -���y�a-ou ��` � (�-a-ia- �3� �{c�
If any portion of the resideniial struciure or the land not exceeding one (1) acre that immetliately surrounds that struc-
ture is used to produce income'describe the use and portion of the property utilized to produce income.
!/�l/�I✓I�
-�• • �
1 hereby certify the above siatemenis are true. correci and
number, city, state and ZIP code)
� —6ez/
ANT IN OTHER COUNTIES
County . Township
ASSESSOR USE ONLV , ._ TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
�and noi exceeding 7(one) acre immediately
surrounding residential improvements (�)
Oiherland (2)
Total land - line (1) plus line (2) (3)
Residential�improvements Dwelling - (4)� - - - � � -
Garage (5) �,T
Other improvements (6) \
Total improvements - line (4) through line (6) (7)
Tota� value - line (3) plus line (.7) (8) AUD OFS
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Aciion - Signature of Auditor Date Signed
7989 Pay 7990
Lesser of 1/2 Homestead
Valuation or $2,500
Signature of Auditor
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 7991 Pay 1992 19—Pay 19—
Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homesiead
Valuation or $2.000 Valuation or �1.500 Valuation or S7,500
Date Signed
