Homestead_Teel (2)�{ R13
eE E CLAIM FOR HOMESTEAD PROPERTY TAX
s; �= CREDIT/ST�4NDARD DEDUCTION
;��� State Porm 5473 (R2 / 5-92)
i'1�'O]
INSTRUCTIONS: See �everse side for liling instructions.
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occupied as our principal place of residence the following described real property for which a
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certify. that on the
�1 (We) owned ❑ Are buying under contract . � � G,a��„! �C�" ``
❑ Have a beneticial interest in the entity ihat is liable for the property taxes on the property and that owns the property or is buying under a contract. .
- � � � ,� CONTRACTRECORDED � � � - . �
It buying on contract, Fee Simple owner's name � • '-
Recorder's office where contract is recorded qecortl number Page
Counry
7/
Parcel number
7 ip
Legal tles�
PROPERTY
II any ponion of the residedtial structure or the land not exceeding one (t) acre that immediately surrounds ihat structure is used ro produce income, describe ihe use and ponion
of ihe propeny u�edp,yo�com� � � � , - . . .
// � ��
� oo�--o�ay-Do
d� - /Q - %G - /od -�so�3,P�a�/
Counry
(number and street. city. sta(e.
Township
correci and cnmplete.
BY CLAIMANT IN
Counry
Sgnawre
. . ASSESSOR USE ONLY � _ TRUE TAl( . ASSESSED HOMESTEAD NON-RESIDENTIAL
- VALUE VALUE VAWE VALUE -
Land not exceeding 1(one) acre immediarely
surroundin9 residential improvements. (�) �
Otherland (2)
Total land (line 7 plus line 2� (3)
Dwelling (4) � -
Residential improvements
Garage (g) - �
Other improvemenis (6) -
Total improvements (line 4 through line � (7)
7otal value (line 3 p�s line 7� (g)
I hereby ceRify the above is true, correCt, and Siqnamre of Assessor- . Date signed
complete.
Veritying action - Siqnature of Auditor Date signed