Homestead_MairM<• �• CLAIM FOR HOMESTEAD PROPERTY TAX
:� ;4` CREDIT/STANDARD DEDUCTION_ .
�.,`��� State Form 5473 (R2/1-90)
INSTRUCTIONS: See.reverse side for filing instructions,
. .,
CERTIFICATION STATEMENT
, /r _•� � � .. .
� �
..G� �f.s ; � ��'�
' MAY 10 1g91
II(We) ���C1JU�T V.`� l.,c�' IC�. �•`"� �� certify that on the 15f����, ,,,, �
;�(We) occupied as our principal place of r idence the following described real property for which a Homestead
Property Tax Credit is hereby claimed: � I(We) owned ❑ Are buying under contract
� Have a beneficial interest in the entity that is liable for lhe pFoperty tazes on the property and that owns the
prqperty or is buying it under a contract.
CONTRACT RECORDED
If buying on contracL Fee Simple Owner's Name � �
Recorder's office where contract is recorded . : Record Number Page '
FROPERTY DESCRIPTION
. . T�..:�� 1'1.���..
Legal p$$crip� I _� _ la
t' �
town, township)
If any portion of the residential structure or the land not exceeding one (t ) acre that immediately surrounds that struc-
ture is used to produce income describe'the use and portion of the property utilized to produce income.
-u� - /Lr� -[.r��. ci.� 7—�P-.
PROPERTY OWNED Bl( CLAIMANT IN OTHER
Town�hin - County .
NTIES
certify ihe above siatemems are Vue. correct and at �
� `��� ✓ n��
>(Street.�{ mber. city. state and ZIP co e) �/ '
`� �Vc�+2,.�s�vt�/� �� "t�%�?C? �
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
NON•RESIDENTIAL
VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvemenis (�)
Otherland (2)
Total land - line (7) plus line (2) (3)
�Resideniial improvements' - Dwefling (4) - • - � - - - - -
Garage (5)
Oiher improvements (6)
Total improvements - line (4) through line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
�
7 989 Pay 7 990
Lesser of 1/2 Homestead
Valuation or $2,500
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991
Lesser of 1/2 Homestead
Valuation or �2,000
1991 Pay 1992
Lesser of 1/2 Homestead
Valuation or $1.500
19—Pay 19—
Lesser of 1/2 Homestead
Valuation or $1,500
Signature of Audiror � � I� �� I Date