Homestead_Dilbeck (3)`� R��° CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
�° � � CREDIT/STANDARD DEDUCTION Hcio
� State Form 5473 (R2 / 5-92�
y�3
INSTRUCTIONS: See reverse side lor /iling instructions.
,.
_ . �.., � . . :. ., �•- , -=+:CERTIFlCATIONSTATEMENT;" � "�r�.� . � _ - . •+.:'..
_ _.
. _ . - ' ° ^ ,;�. � ' -
.... . .. _ . _< _�:'_ � �r�. �
ccwe) _ certiryma�o is4'�a� a�is4��J
e upied s r principai place of residence the following described real properry tor which a Homestead Property Tau Credit is hereby claimed:
I1(We) own d ❑ Are buying under contract ��j 2 8 1998
❑ Have a beneficial interest in the eniity ihat is liable tor the property taxes on the property and thai owns ihe pro�'rty or is buying uoder a contraa.
�� �/ � � �l �
. `; � '`"'-�-:—t'
/v riacrn� .-�. J�: -.
� . .- _ . : _ . CONTRACT RECORDED <:- _ � . _ . � , _ _. � _ -. , v., • "� �••.o Y?o; '
If buying on contract, Fee Simple owner's name
Recorder's oHice where contract is recortletl
Retord number I Page
- . . � ° � .PROPEPTYDESCRIPTION � ."" °`. . . ..... . . .
Counry Township Ta�cing district (dry, lown, w shi )
r�� r n Legal descripiion
7
It any ponion ot ihe residential siruaure or the land not exceetling one (1) acre that immediatety surrounds ihat swcNre is used ro produce income. tlescnbe Ne use arW ponion
of Ne D�oDenY uulized to produce income.
a� - /�'� 5� �D /-./�OD. 9��Gb7,S
PROPERTY OWNED BY CLAIMAM IN OTHER COUNTIES �
Counry Townshi Coun Township
,ieby certify the above siatements are irue, correct and complete. Signamre o( daima �
ress (number and sbeef, ciry, state. ZIP cade)
�^ i. r �o�-
i
= ASSESSOR USE ONLY TRUE TA7C ASSESSED HOMESTEAD� NON-RESIDENTIAC
VALUE VALUE VALUE VALUE �
Land not exceeding 7(one) acre immediately � � -� -
surrounding resideniial improvements. (�) � � �
Other land (p) ' . .
�._
Total land Qine 7 plus line 2� �3)
Dwelling (4) � � �� ' :
Residential improvements .
Garage (5) � . .
Other improvemenis (6) -
Total improvements (line 4 Ihrough line � (7)
Total value Qine 3 pbs line � (g)
1 hereby Certity the above i5 true, corrett, and Signa:ure of Assessor Date signed
complete.
yirg action - Siqnature of Auditor , Date signed
� STANDARD DEDUCTION ALLOWANCE- - -' �� -
19_Pay19_
Lesser of 7l2 Homestead
Valuation or 52,000 $
Sgnature ot Autliror Date sgned