Homestead_Winstead.�
`�E��n g CLAIM FOR HOMESTEAD PROPERTY TAX
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;,��p�e�u��'� CREDIT/STANDARD DEDUCTION '
,�fm�.%�� Stare form 5473 (R2/5-92)
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INSTRUCTIONS: See reverse side foi liling instructions.
CERTIFICATION STATEMENT .
FORM YEAR
HC10
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I�We) d1,�,J �(�(y,d/ �--: _ . certify that on th/g� 7 st day of March, 19� t7
����) occupi d s our principal place of residence the following described real property for which a Homestead PropertyQ�qBrpQ�js j�teb��j�.�
!l� (We) owned ❑ Are buying under contract � AUDITOR �,
❑ Have a beneficial interest in ihe entiry that is Iiabie for the property taxes on the property and that owns the property or is buying under a contract.
CONTRACT RECORDED - - � . "
It buying on coniraa, Fee Simple owner's name - . -'
Recordefs oHice where contract is remrdetl Recortl number Page
County
DESCRIPTION
Tdxinq tli5lric�ity tOwn, fownship)
Parcel number Legal desc �^" n\J U V
�op5- 035�;3 �j,� �£ N�' �-3-Ia � I.I� ►�C
If any ponion oi Ihe residential strucwre or the lantl not exceeding one (1) aae ihat immediatety surwunds that s[mcWre fs used to produce income. descnbe Ne use and portion
of the propeny utilized to produce incame.
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ASSESSOR USE ONLY � TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAI
VAWE . VALUE VALUE VALUE
Land noi exceeding t(one) acre immediately
surrounding residential improvements. (�)
Otherland (p) �
Total land (line 7 p/us line 2� (3) �
Dwelling (4) �
Residential improvements
Garage (5)
Other improvements (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � (g) I
I hereby Certify lhe above is �rue. CArreCi, and Signature of Assessor Date signetl
complete.
�ying action - Synature of Auditor Date signed
STANDARD DEDUCTION ALLOWANCE
I79_Pay79_ .
Lesser of l/2 Homestead
Valuation or 52,000 5
Signature 1 uditor Date signed
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