Homestead_McGrew�"` """ - CLAIM FOR HOMESTEAD PROPERTY TAX
� � CREDIT/STANDARD DEDUCTION '
:
�_� i• State Fortn 5473 (R2 / S92)
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and that owns the property or is buying under a contract.
- CONTRACTRECORDED
II buying on contract, Fee Simple owners name
Recordefs office where contract is recortletl Recortl numDer Page
PROPERTY DESCRIPTION
Counry ip Ta�cingdist' ,town. wnshipJ
Parcel number Legal descripti
� � d
II an portion o the residential siructure or ihe land not exceedin one 1 acre that immediate surtounds ihat swciure is use e� escribe ihe use antl rtion oi
the properry utilized to produce income. 9 () N QNiYPdy4 i+{�W9�S'nQ P�
I I/aT �f O LUII l
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O((O – Q– 6_QQ,3. %7 —Qo� GIB��:SY AU�
� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Townsttip _ Counry Township
5 n tur f claimant
�reby certify the above statements are true, correct and complete. C
ddress (number ana sfreef, dry, state, ZIP code)
2 �/.�
ASSESSOR USE ONLY �UE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not ezceeding 7(oneJ acre immediately (�)
sunounding residenfial improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residentia� improvements
Garage (5)
Other improvemenis (6)
Total improvemenis (line 4 through line 6) (7)
Total value (line 3 plus line 7J (8)
I hereby certify Ihe above is irue, correct, and Siqnature of Pssewr Date signed
complete.
Veritying ac6on - Signature of Auditor Date signetl
� STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
ser of /2 Homestead �
ati n or 52,000
Signature oi AuEitor / Date signed
5 -�-D
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