Homestead_Blackard (3)�
������ CLAIM FOR HOMESTEAD PROPERTY TAX
,.. - .. �
���` ; CREDIT/STANDARD DEDUCTION
•`�� Stale Form 5473 (R2/1-90)
INSTRUCTIONS: See reverse srde lor liling insiruclions.
I (We)
CERTIFICATION STATEMENT
FORM
HC10
�
certify that on ihe 1 s[ day o( March , 19
I(We) occupied as our principal place of residence t,he �following described real properly for which a Nomeslead
,roperty Tax Credit is hereby claimed: �CJ �(We) owned ❑ Are buying under coniract
� Have a benelicial interesl in Ihe enlily Ihat is liable for Ihe properry laxes on tl��p�rlv� �wns ihe
property or is buying it under a contract. g� �.d
Counly
on coniracl, Fee Simple
where contract
Townsliip
CONTRACT RECORDED
PROPERTY DESCRIPTION
Taxing Disiric
MAY � 199%
�r�n.a� �'.
townsliip)
Parc um e Legal Description ��� � � �� � , �,/O /
)n����-OU � ir�
If any portion of the residential siructure or lhe land nol exceedmg one (1) acre Ihat immediately surrounds that struc-
ture is used to produce income describe Ihe use and porlion of the properly utilized to produce income.
�'- /9- 69-�300 -�/ /�� - ao?�
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY
TRUE TA% VAIUE ASSESSED VALUE F10MESTEAD VALUE
NON-RESIDENT�AL
VALUE
Land nol exceeding 1(one) acre immedialeiy
surroundingresidenfialimprovemenls (�)
Olher land (2)
Totat land - line (1) plus line (2) (3)
Flesidential improvemenls Dwelling (4)
Garage (5)
Olher improvemenls (6)
Tolal improvemenls - line (4) lhrough line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby cerlily ihe above is irue, SignaWre ol Assesor Dale Signed
correct, and complete
Verilying Action - Signature ol Audilor Date Signed
1989 Pay 1990
�ser oi 1l2 Homeslead
Valualion or $2,500
Signalure of
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 1991 Pay 1992 19 _ Pay 19 —
Lesser ol 1/2 Homeslead Lesser of 1/2 Homeslead Lesser ot t/2 Homestead
Valualion or $2,000 Valuation or $1,500 Valualion or $1,500
Date S' ne /�
'i'—'1 ' � � O`