Homestead_Riggse%�""°� CLAIM FOR HOMESTEAD PROPERTY TAX FORM AR
;��': CREDIT/STANDARD DEDUCTION riC�o �
�;�� State Form�5473 (R2 / 5-92)
�eTs
INSTRUCTIONS: See ieverse side lor tiling instructions.
buying under coniract � v
❑ Have a beneticial interest in the entity that is liable for ihe property taxes on ihe property and ihat owns
contract.
� - � � � CONTRACTRECORDED.� � �—n
tl buyrtg on contracL Fee Simple owner's name ,. � � � - ° �`�
Remrder's oHice where contract is recortled g�� nu,ip�ber ��' � Page
- AUDITOR�
County
PROPERTY DESCRIPTION
Township . Tacing diStriCt (Ciry. town,
P rcel num�r legal de5tription
�o.� =cb90 g-o0 � � �. ;l . Vl �. 5- 3- 1 �J.Ooaz�
I! any ponion of the residential strucmre or the land not exceeding one (7 � acre ihat immediately surrounds ihat structure is used ro produce income, desaibe the use antl portion
of the properry utilizetl to protluce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County Townshi _
�-eby certify the above statements are irue, correct and complete. Signawre o� ciaiman�
�dre55 (number and siree(, ciry, s(ate, ZIPa�tle)
.
. S�7GGs'
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENiIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately I
surrounding residentiai improvements. �� �
Otherland (p)
I
Total land (line 7 plus line � (3)
Dwelling (4)
Residential improvemenis
Garage (5) �
O�her improvemenis (6) �
Total improvements (line 4 thiough line � (7)
Total value (line 3 p�s line � (g)
I hereby certify ihe above is true. correci, and Signamre of Assessor Dare signed
complete. -
�fyi�g aclion - Signamre of Autli:or Date signed