Homestead_Thomase°/-''� g CLAIM FOR HOMESTEAD PROPERTY TAX �
i;� -�9 :� CREDIT/STANDARD DEDUCTION '
.'�,.�� State Form 5473 (R2 / 5�92)
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INSTRUCTIONS: See reverse side for �iling instructions.
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I-IWe) _► � I! �l � Y`_�=, �C1J1��[j1 �__�L� certify Ihai on the 15t day of Mamh, 79
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�) occupied as our prmcipal place of residence ihe follo:�� described real property for which.a Homestead Pmperty Tax Credit is hereby claimed:
(J 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 that owns the property or is buying under a contract.
� CONTRACT RECORDED � - � - -
If buying on contract, Fee Simple owner's name • . � � �
Recorder'S o"ice where Contract is retorded Record number Page
Parcel number
Township
Legal de�p�ion
�/�-�J "�J 1 1 ti J 1 I
If any ponion of the residenfial structure or the land
of the pmperty utilized to produce income.
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DESCRIPTION
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C�I�L� � 5'�—�I. �1
) aae that immediatety surrounds that swcNre is used m protluce income, tlescribe ihe use and portion
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ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvementa (�) �
Otherland (2)
Total land (line 1 plus line � (3) -
Dwelling (4) �
Residential improvements
Garage (5)
Other improvements (6)
Total improvemenis Qine 4 through line � (7)
Total value (line 3 p�s line � (g) .
I hereby Certify ihe above is IrUe, wrrect, and Signawre of Assessor Date signed
complete.
�rying action - Sgnature of Audiror Date signed
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STANDARD DEOUCTION ALLOWANCE �
I79 _ Pay 79 _ •
Lesser of 1/2 Homestead
' Valuation or 52,000 S
Signature ot Auditor Date sgned