Homestead_Arbuthnota�—��
°4 CLAIM FOR HOMESTEAD PROPERTY TAX
s;��� CREDIT/STANDARD DEDUCTION
�,;�� State Form 5473 (R2 / 5-92)
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INSTRUCTIONS: See ieverse side lor liling instructions.
, � CERTIFICATION
-- FORM nYEAR
H = �` � 1 L l
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�^ve) �b.JlhM1.4� �' \_MY.�'�^� `^`O'� certify that on t�tyt�laq.6tf,�61ar'c!ti1,%ote ��".
) occupied as our principal.place of residence the.following described real property for whicha Homesiead Property Tau Cre�}.�ce�eoy�e�aimed
I �(We) owned ❑ Are buying under contract . _ � � . _
❑ Have a beneficial inierest in the entity that is liable tor ihe property tazes on ihe property and that owns the property or is buying under a comraci.
� � .CONTRACTRECORDED -
It buying on contract. Fee Simple owners name . � . � �
Recorder's oftice where mntract is recorded Record number Page
Counry
PROPERTY DESCRIPTION
Tauing dis�rifi (city town, township) -
Parcel number Legal ion
oo�-e�og� �� N� �t,� 4-3-�o I.eo �4C
It any ponion of ihe residential stmcwre or the land not exceetling one (1) acre that immediatety surwunds ihat swcwre is used to produce income, tlescribe the use and ponion
of the property utilized to produce income.
-�9- 09- �oo-�oo.o�'� -�3�
ASSESSOR USE ONIY . TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
, VAWE VAIUE. VALUE VALUE
land noi exceeding 1(one) acre immediately
surrounding residential improvements. (�)
Otherland (p)
7otal land (line 7 plus line Z� � (3)
Dwelling (4) � �
Residential improvements ,
Garage (5) �
Other improvements (6)
Total improvements (line 4 thiough line � (7)
Total value (line 3 p�s line � (g) I
I hereby Certi�y the above is irUe, correCi, and Signature ot Assessor Date s"gned
complete.
�Fg action - Signature ot Autlitor Date signetl
l
STANDARD DEDUCTION
79_ Pay 79_ I
Lesserof 7/2 Homestead
Valuation or 52.000 S