Homestead_Knowels�Yf nriF
� � CLAIM FOR HOMESTEAD PROPERTY TAX.
ii�'= CREDIT/STANDARD DEDUCTION
.�. .�;�;� State Form 5473 (R2 / 5-92)
�u� .
INSTRUCTIONS: See reveise side /or tiling instmctions.
FO E
Hc�o MAR 2 6 199�
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I(We) �! ��, � l,( ��l.(.�Q }`LYC 5! -�i� � certify that on the 7 si day of March. 19�
�e) occupied as our principal place of residence the f I wi scribed real property for which a Homestead Property Taz Credit is hereby daimed:
u I(We) owned ❑ Are buying under contract . � ...
❑ Have a bene(icial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
- - , CONTRACTHECORDED � • � �
It buying on coniract, Fee Simple owner's name � . •• . '�
Recorder's oHice where wntrect is remrded Recortl number Page
Counry
PROPERTY DESCRIPTION �
. � Tazing tlisuict (ciry, fown, township). �
Parcel nGmber Legal description U
�o5-a37i9=t�D P+- r.� -3-ia� (do_.��
If any portion ot ihe resitlential stmcwre or the land not exceeding one (7 � aue that immediatey surmunds that structure is used to produce iricome, descnbe the use antl portion
of the pmperty utilized ro produce income. _ _ _
I a/-i� oa-aoo=�oa���i9--��/ ' I
ASSESSOR USE ONLY �..� TRUE TAX ASSESSED HOMESTEAD �NON-RESIDENTIAL.
. � VALUE VA�UE- VALUE VALUE
Land not exceeding 1(one) acre immediately �
surrounding residential improvements. (�) .
Otherland (p)
Total land (line 1 plus line 2� (3)
Dwelling (4)
Residential improvemenis
Garage (5) � �
Other improvements (6) .
Total improvements (line 4 through lina � (7)
Total value (line 3 pbs line 7) (g�
I hereby certify the above is ime, correc4 and Signature ot Assessor Daie signed
compiete.
�tyirg action - Signature of Audiror Date signetl
79_Pay19_
Lesser of 1l2 Homesiead
Valuation or 52.000
DEDUCTIONALIOWANCE
S
Date
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