Homestead_Mobley (2)�yE �`��I
e� " E CLAIM FOR HOMESTEAD PROPERTY TAX
;E�!: CREDIT/STANDARD DEDUCTION `
.�.-;�� State Form 5473 (R2 / S92)
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INSTRUCTIONS: See reverse side 7oi liling ins(ructions.
FORM YEAR
o- y
. �
�eav 16 1994
1__ {�y_���� w,(
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❑ Have a beneficial inierest in ihe entiry thai is liable for the property taxes on ihe property and thai owns the property or is buying under a contraa.
� � CONTRACTRECORDED. -
It buyirg om m�traa. Fee Simple ownefs name � � �
Recordefs oftice where wntract is remrded Recortl number Page
County
Pa¢el number
If any portion oi t17'e resid
of the pmperry utilizetl m
PROPERTY DESCRIPTION
Township . . Tazi distriCt ciry, town,
/(11 �
Legal de5aiption
��-c.-� i /—�� ,a-� oc 7��—� o� oc - 7�r�c.
swcwre or ihe tand not exceeding one (1) aue ihat immediatety surrounds that swcture is used to produce income, descrihe ihe use a� portion
ice inmme.
_, , -��� ,-
3-
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES -
County Township County Township
�eby certify the above siatements are true, correci and complete. Sig mre o� da an2 �
i
Address (numberantlstreeL ciry, sfate. ZlPwde) .
ASSESSOR USE ONLY TFiUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvements. (�)
Oiherland � (p)
Total land (line 7 plus line Z� (3) _
Dwelling (4)
Residential improvemenis
Garage (5)
Other improvements (6)
Total improvements (line 4 through lina � (7�
Total value (line 3 pbs line � (g)
I hereby certify Ihe above is irue, COrreCi, and Synature of Assessor . Da;e slgned
complete.
mg action - Signamre of Auditor Date signed
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