Homestead_Rainey�R�
� i CLAIM FOR HOMESTEAD PROPERTY TAX
i��� CREDIT/STANDARD DEDUCTION
,�.`�� - State Form 5473 (R2 / 5-92) .
�a� .
INSTRUCTIONS: See reverse side /orliling instructions.
. . . . . � . _ PCOTCIlV1T1
FORM YEAR
_ O. .
� 17 1991
irwe) ��-ava.k+ c��I.LG '7 V a�����— _ �-�,�r�a ,s
—r--. ��; �:,�n: �l.ti —
��) occupied as our principal place of residence the following descnbed real property tor w� stea ���'f��pErty ax Credit is hereby claimed:
[� I(We) owned � ❑ Are buying under contract .
❑ Have a beneficial inierest in the entiry that is liable for ihe property taxes on.the pmperty.and that owns the pmperty or is buying under a contraci.
- - . ' CONTRACT RECORDED - ' � � ' �� -� .
If buying om m�tract, fee Simple owners name � � �-, '-
Recorder's oflice where contract is recortletl Record number Page
County �
Parcel
E-
. Township'
Legal
portion oi the resitlential stmcmre or the land not
pmperty utilized ta produce income.
=
PROPERTY DESCflIP'TION
7 ing dis
� acre ihat imm iatety surround:
� _�/. a�G - �
r —� (/J
that structure is used to
Use d�td pOrtion
' PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES �
Couniy TownShip Counry � TownShip
�eby certity the above statemenis are irue, correct and complete: Signamre claimam
Ad s (numberandstreeLdry.stare. 1PCOde) ^
� � � �
. ASSESSOR USE ONLY . TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
land not exceeding 7(one) acre immediately
surmunding residential improvemenis. (�) . � '
Otherland (p)
Total land (line 7 plus line 2� (3� �
Dwelling (4) _
Residential improvements , .
Garege (5)
Other improvements (6) -
Total improvemenis Qine 4 through line � (7) �
Total value (line 3 p�s line 7� (g)
I hereby certify ihe above is irue, correct, and Sgnamre ot nssessor Dare signed
complete. �
v��rying action - Synature ot Auditor Date signed
�
� � . STANDARD DEDUCTION ALLOWANCE . -
19_Pay79_
Lesser of 1/2 Homestead
Valuation or 52.000 � �
SignaNre of Audiior Dale signed
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