Homestead_Littlepaged�-•�• � CLAIM OMESTEAD PROPERT•Y TAX
�_� - � = CREDIT/STANDARD DEDUCTION � -
� :� State Form 5473 (R2/1-90) •��
�'°�• � INSTRUCTIONS: See reverse side for �iling instructions.
CERTIFICATION STATEMENT
FORM YEAR
HC10 �O
• : ap5 - o10�f �
I(We) '�� __ _ C�.�Ra�. certify that on the t st day of March , 19 g�
�Ne) occupied as our principal place of residence the following described real property for which a Homestead
operty Tax Credit is hereby ciaimed: �� (We) owned ;� -Are buying under contract
� Have.a beneficial interest in the entity thaYis liable for the property taxes on the property and that owns the
property or is buying it under a contract. , �
CONTRACT RECORDED�� �
on contract. Fee Simple Owner's Name
's office where contract is recorded
PROPERTY DESCRI
County
town,
Parcel Number Lega scrip lon ' �
rr, S- OI O'�% � �. F �(1- 1- -I I `f. I 8►� � '
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe ihe,use and portion of the property utilized to produce income.
- r %�_ //--�'i�-- �1'/1/J�-�Yi//1�—/J�2%
PROPERTY OWNED�BY CLAIMANT IN OT
Township County
�ere6y certify itie above statements ai
mplete.
Address (Street, number, city, state
ASSESSOR USE ONLY
C�Z�1�L`�l
correct and I Sign re � ��..� MAY
. k i/�cd��f0�
IP code)
� �
TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
9 ]990
NON•RESIDENTIAL
VALUE
Land not exceeding 7(one) acre immediately
surrounding resideniial improvements (�)
Other land (2)
Total land - line (t) plus line (2) (3)
. _Residential improvements _ Dwelling. _ .(4) .. _ _. _ _ .
Garage (5)
Other improvements (6)
Total improvemenis - line (4) ihrough line (6) (7)
Total value - tine (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
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990 1990 Pay 1991 1991 Pay 1992 19 — Pay 19 —
�Lesser of 7/2 Homestead Lesser of t/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or $2,500 Valuation or $2,000 Valuation or $7,500 Valuation or �7,500
.�'
Signature of Auditor Date Signed
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