Homestead_Scott (5)%� �� CLAIM FOR HOMESTEAD PROPERTY TAX
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:t� CREDIT/STANDARD DEDUCTION
Slale Fonn 5473 (R2/i-90)
'^ ` lNSTRUCTIONS: See reverse srde !or liling inslrucfions.
CERTIfICl1TION STATEMENT
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MAY 11 1992
( � `.Y/W`�l � Y Y �J A ��
I We `�' �• `�'`^ ceitif Ihat on Ihe 1st da of MaroiiU�T
I(We) occupied as our principal place of residence lhe lollowing described real properly lor wliich a I lomestead
��perty Tax Credit is hereby claimed: ,[�-1�(We) owned ❑ Are buying under contracl
� Have a beneficial inleresl in Ihe enlily Ihal is liable (or Ihe properly laxes on lhe properly and Ihal owns the
propetly or is buying it under a conlracl.
CONTRACT RECORDED
II buying on conlracl, Fee Simple Owner's Name
Recorder's ollice where coniract is recorded Fiecord Number Page
PROPERTY DESC(iIPTION
Counly
(Cily, lown, lownship)
Parcel Number Legal Des'efiplion �
oos- ��o�a � �� 3a-a-il �q.al�sRc,
II any portion of lhe residenlial slructure or Ihe land nol exceeding one (1) acre Ihal irnmedialely surrounds lhat siruc-
lure is used lo produce income describe Ihe use and porlion of the properly ulilized to produce income.
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PROPERTY OWNED BY CLAIMANT IN OTI1Efi COUNTIES
ASSESSOR USE ONLY Tt1UE TAX VALUE ASSESSED VALUE IIOMESTEAD VALUE NON-RESIDENiIAL
VAIUE
Land nol exceeding 1(one) acre iumiedialely
surroundingresidenlialimprovemenls ��)
Olherland (Z)
Tolal land - line (1) plus line (2) (3)
Residenlial itnprovemenis Dwelling (4)
Garage (5)
Other improvements (6)
Tolal improvemenis - line (A) Ihwugh line (6) (7)
Tolal value - line (3) plus line (7) (8)
I hereby certify lhe above is Irue, Siynalure ol Assesor Dale Signed
correcl, and complele
Verilying Aclion - Sgnalure ol Audilor Uale Signed
1989 Pay 1990
�sser of 1/2 Flomestead
Valualion or $2,500
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991
Lesser oi 1/2 Homeslead
Valuation or $2,000
�
1991 Pay 1992 19 — Pay 19 —
Lesser ol 1/2 liomeslead Lesser ol 1/2 Flomeslead
Valualion or $1,500 Valualion or $I,500
Signalure oi Audilor Date Signed
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