Homestead_Marvel6��"� i CLAIM FOR HOMESTEAD PROPERTY TAX
�a�"s CREDIT/ST�CNDARD DEDUCTION
� State Porm 5473 (R2 / 5-92)
ti�
�a� .
INSTRUCTIONS: See reverse side !or tiling instrucfions.
� �- � ' - � �CERTIFICATI
FORM
HC10
�
.
�( ) � � ' cenify� thai on ihe t st day of March. 19
pied as our principal pi c ot residence the follo� .ng descnbed real property for which a Homestead Property Tax Credit is �hereyby Gaimed:
�(We) owned ❑ Are buying under coniract � _ � �� 9� • �
�{1
❑ Have a beneficial in,eresi in ihe.entiry thai is liable for the property taxes on the pmperty and that owns the propert r is y g dndera ct.
It buying on coniract, Fee Simple owner's name
Recorder'S oHice where contrect is recortletl
County
CONTRACT
PROPERTY DESCRIPTION
e Legal tlescription •
�-n3d13-0� - -
of the residential structure or Ihe land not exceeding one (7) acre ihat immediatety surmunds that strucWre
y utilized to produce income.
' // vSd' 47CXJ � (��J. (//v-vo�-i
PROPEFiTY OWNED BY CLAIMANT IN OTHEH COUNTIES
certify the above statements are true, co« ect and complete.
ASSESSOR USE ONLY
Land not exceeding 1(one) acre immediately
surroundinq residential improvemenis.
Other land
Total land (line 7 p/us line 2�
Dwelling
Residential improvemenis
Garage
Other improvements
Total improvemenis (line 4 through lina �
Total value (line 3 p�s line �
I hereby certify ihe above is true, correct, and
complete.
Verihrim action - Sianamre of Autlitor
TRUE TA7C
VALUE
l�)
(z)
(3)
l4)
(5)
(6)
P)
(8)
Sgnature of Assessor
y
to
ASSESSED I HOMESTEAD
VALUE VALUE
income, describe the use and ponion
Townstup
NON-RESIDENTIAL
VALUE
Date signed
Date signed
� STANDARD DEDUCTION ALLOWANCE ' � � -
19_Pay79_ .
Lesser of 1/2 Homesiead
Valuation or 52.000 g
Sgnamre of Auditor � Da;e signed