Homestead_Tichenor (4)ai=~"
� °4 CLAIM FOR HOMESTEAD PROPERTY TAX
���� CREDIT/STANDARD DEDUCTION
,.�p ,;� SlatePorm5473�R2/5-92)
�iL .
INSTRUCTIONS: See reverse side 7or Iiling instructions.
STATEMENT
oceupied as our principal place of residence the following
i. ,, �
I ' ��� , �I1�
' e ��� �
/ �
_ �
certify ihat on ihe 7st day of March. 79_
a Homestead Property Tax Credit is hereby claimed:
I(We) owned ❑ Are buying under coniract �—'� 7 �
Have a beneficial interes� in the en�ity ihat is liable for the property taxes on ihe property and thai owns the property or is buying under a contract.
CONTRACTRECORDED ' . -
If buying on coNract, Fee Simple owner's name .
Recorder's ottice where contract is recorded Record number Page
Counry
Parcel number
PROPERTY DESCRIPTION
Township � Tazing districi (ciry, rown, fownship)
Legal
f the residential structure or the lantl not exceeding one (7) acre that immediatety surmunds that structure is used to produce ir�come, tlescribe Ne use and portion
uiilized to produce income.
�/o?- �4-D�d_
ASSESSOR USE ONLY , TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE � � VALUE VAWE
Land not ezceeding 7(one) acre immediately
surrounding residential improvements (� � � �
Oiherland (2)
Total land (line 7 plus line 2� (3)
Dwelling (4) �
Residential improvemenis
Garage (5� .
Other improvements (6)
Total improvements (line 4 thmugh line � (7)
7ota1 value Qine 3 pbs line 7) (g)
I hereby certify the above is Irue, correct, and . Signamre ot Assessor Date sgned
compiete.
"^�i " action - Signature of Auditor Dare sgned