Homestead_Michel„.,•..
e�/>” °„ CLAIM FOR HOMESTEAD PROPERTY TAX
���',; CREDIT/STANDARD DEDUCTION
.`�.�� • Sta�e Porm 5473 (R2 / S92)
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INSTRUCTIONS: See reverse side lor filing instmctions.
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1(We) ��jj�J �fJ. °�-� U/YV�PJ(,1.0-. �i 1�(�tnO.X- - certify th n the tsi d,taLy of.March, 19 1�-
,�) occupied as our principal place of residence the following described real property for which a Homesiead Pr�v,qy79�-CrCtli �is et�imed:
�, I(We) owned ❑ Are buying under contract AUDI����
❑ Have a beneticiai interest in the entity that is liable for ihe property taxes on the property and ihat owns ihe property or is buyinq under a contract.
- � - CONTRACT RECORDED � - . �
It buying on contract, Fee Simple owner's name�� _ �. _-
Recorder's oflice where contraa is recortled Recorcl number Page
Couniy
Parcel number
�5-oil I
I( any ponion of the resid
ot ihe property utilized ro
I �
Legal escr"
tial stmcture or the land not ex
oduce income.
�Y/ — � � �CO -
PROPERTY
one (7) aCre
�
Taxirg di�i�(Ciry. lowq township)
� r"
I� - 3-�a ! - � ��-
ty wrmunds that strucNre is usetl to produce income, describe ihe use aM portion
� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township Counry �- Township
—
�eby certify Ihe above slatements are true, correcl and complete. Signature of claimant � '
ress (number and streei. dry. state, ZIP code)
� 12 3 3 3 I W evts ��( Zf�! %(e (n s
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VAIUE VA�UE
land not exceeding 7(one) acre immediately
surrounding residential improvements. (�) -
Otherland (p)
Total land (line 7 plus line � (3)
Dwelling (4) '
Residential improvemenis
Garage (g�
Other improvements (6)
Total improvemenis Qine 4 through line � (7)
Total value (line 3 pVs line � (g)
I hereby certify Ihe above is irue, correCt, and Signamre of Assessor Da;e signed
complete.
�tying aaion - Signature of Autliror Date signetl