Homestead_Roberts (2)rt••���E CLAIM FOR HOMESTEAD PROPERTY TAX
d��4�` CREDIT/STAN�DARD DEDUCTION
: x'-� ,; `
•`.` .� State.Form 5473 (R2/1-90)
INSTRUCTIONS: See reverse side for liling ;nstructions.
� � CERTIFICATION STATEMENT
FORM YEAR
H�,o g�
p� , b� s��-1,. .
I(We) � �.'d' ' ,
following described real property forwhich a Homestead
�erty Tax Credit is hereliy claimed: I(We) owned ❑ Are buying under contract
� Have a beneficial interest in the entity that is iable for the property taxes on the pro� d Do the
property or is buying it �under a contract. �����
�
,�- CONTRACT RECORD�D itii 51 7QQ(1
County
on contract, Fee Simple Owner's Name� //a� ,c!/a�/s��
/U
's oifice where contract is recorded F
i i � PROPERTY DESCRIPTION
�Legal
,i,
ng District (City, town,
.
If any portion of the residential siructure or the land not exceeding one (1) acre that immediately surrounds that struc-
�e is used to produce income describe the use and portion of the property utilized to produce income.
�I
County
�
)PERTY OWNED BY CLAIMANT IN OTHER COUNTIES
: Township County Sn�emehjp
cehify ihe above statements are irue, correct and
I6O NtiQ �
�3 300ASSESSOR USE ONLY .: � TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
ii_')n nIQ •ii
Land not exceeding 1(one) acre immediately
surrounding resideniial improvemenis
Otherland �
Total land - line (7 ) plus line (2) •
Residential improvements � Dwelling
Garage
Oiher improvemenis �
Total improvemenis - line (4) ihrough line (6)
�al value - line (3) plus line (.7)
�ereby certify the above is true,
correct, and complete
Vorifvinn Actinn - Ainnafura nf Anriitnr
�1989 Pay 1990
esser of 7/2 Homestead
Valuation or $2,500
(�)
(2)
(4)
(5)
(6)
n)
(8)
Signature of Assesor
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 1991 Pay 1992
,Lesser o( 1/2 Homestead Lesser of 1/2 Homestead
Valuation or $2,000 Valuation or $1,500
NON•RESIDENTIAL ���
' �" VALUE � '
19—Pay 19—
Lesser of 1/2 Homestead
Valuation or $1,500
Signature of Auditor � � n I Date