Homestead_Lynch�`�'""°< CLAIM FOR HOMESTEAD PROPERTY TAX
� '� CREDIT/STANDARD DEDUCTION
;
.
�.�i' Siate Portn 54731R2 / S92)
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INSTRUCTIONS: See reverse side lor (ling instructions. . .
'� CERTIFICATION STATEMENT
�� ?� "-.� fOR � YEAR
►!
APR � "����°
I(We) certity that on the ist day of March. 79_
I(We) occupied a ur principa place of residence the following described real property for which a Homestead Property Ta�c Credit is hereby claimed:
We) owned ❑ Are buying under contract
Have a beneficial interest in Ihe entity that is liable for the pmperty taxes on the pmperty and that owns the pmperty or is btrying under a contract.
CONTRACT-RECORDED
contraa.
name
^� �
cture or th
PROPERTY
acre
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Township � Counry
certify the above statements are true, correct and complete.
�mber and streef, ciry, state, ZlPyrode�.� � �
� ASSESSOR USE ONLY
Land not exceeding 1(one) acre immediately
surrounding residential improvements.
Otherland
Total land (line 7 plus line 2)
Dwelling
Resideniial improvements
Garage
Oiher improvements
Total improvements (line 4 through line 6J
Total value (line 3 plus line 7J
I hereby certity ihe above is true, correct, and
complete.
79_ Pay 19 _
Lesser of 1/2 Homestead
Valuation or 52,000
TRUETAX I ASSESSED I� HOMESTEAD
VALUE VALUE VALUE
(�)
i21
(3)
(4)
(5)
(6)
l�)
(8)
STANDARD DEDUCTION ALLOWANCE
$
me use afW
NON-RESIDENTIAL
VALUE
Date signed
oi Auditor. . n � Da[e signed