Homestead_Sisk (2)�f iT��Q � . .
1 „ CLAIM FOR HOMESTEAD PROPERTY TAX
', ��� CREDIT/STANDARD DEDUCTION
,�`'� State Porm 5473 (R2 / 5-92) �
�r7
iiie
INSTRUCTIONS: See reverse side (or7iling instiuctions.
� �
`� , ,, ��
� . � ; ;•� �I.�.�
{NAR 15 19Q?
,�/, � v ,
�"'We) . � l7 �-1 -\� � cenify�that on the 7s ay of March, 79
g) occupied as our principal place of residence he following described real property for which a Homestead.Property Tax Credit is hereby Gaimed:
I(We) owned ❑ Are buying under contract
❑ Have a beneticial interest in the entity that is liable for the property taxes on the property and ihat owns the property or is buying under a contract.
. CONTFiACT RECORDED
If buying on conttact, Fee Simple owner's name
Recorder's ottice where contract is recordetl Recortl number Page
Counry
PROPERTY DESCRIPTION
. Ta�cing distrip (ciry. town. township)
Parcell�u�er �����'�� legalde�:�t� ` �� .� �— �— // � . /O� � .
l V� T w
If any portion of the residential strucmre or the IarM not ezceetling one (1) acre that immediatety surrounds thai strucWre is used to produce irqome. descnbe Ne use arW portion
of the pmperty uolized m produce income.
. ���— �d-/
ASSESSOR USE ONLV , � TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvements. (�)
Oiherland (2)
Total land (line 7 plus line � (3) -
Dwelling (4)
Residential improvements
Garage (5)
Other improvements (6)
Total improvemen[s (line 4 through line � (7)
Total value (line 3 p�s line 7� (g)
I hereby certify �he above is irue, correct and Signamre ol Assessor Date siqnetl
complete. �
Ying action - Signature of Auditor Date signed
DEDUCTION ALLOWANCE
79 Pay79_ I
Lesser ot 1/2 Homesiead
Va�uation or S2,000 � S