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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R2/1-90) "
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
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� AUDITOR
I(We) � (� l�V n.n�..Q..Q�J certify that on the 1 st day of March , 19 �
`(We) occupied as o rincipal place of residence th following described real property for which a Homestead
Property Tax Credit is hereby claimed: I(We) owned ❑ Are buying under contract
� Have a beneficial interest in the entity that is lia le for the property taxes on the property and that owns the
property or is buying it under a contract. '
CONTRACT RECORDED
If buying on contracl. Fee Simple Owner's Name
Recorder's office where contraci is recorded Record Number Page
PROPERTY DESCRIPTION
, Taxing Distric
Number
-00oo�7—aU
If any portion of the residential.structure or the land not exceeding one (t ) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
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ROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding 1(one) acre immediately
surrounding resideniial improvements (� 1
Otherland (2)
Total land - line (1) plus line (2) (3)
Resideniial improvements Dwelling - (4)
Garage (5)
Other improvements (6)
Total improvemenis - line (4) ihrough line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
1989 Pay 1990
Lesser of 7/2 Homestead
Valuation or $2,500
Signature of Auditor
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 1991 Pay 1992 19—Pay 79—
Lesser o( 1/2 Homestead Lesser of 7/2 Homes[ead Lesser of 7/2 Homestead
Valuation or $2.000 Valuation or $1,500 Valuation or $1,500