Homestead_Douglas (10)��� CLAIM FOR tIOMESTEAD PROPERTY TAX
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� ���) CREDIT/STANDARD DEDUCTION
`!�'�,� S�ale Fonn 5473 (fi2/t-90)
'��� WSTRUCTIONS: See reverse side lor liling inslruclions.
CERTIFICATION STATEMENT
MAY 81992
I (We) __��A� °'. '�--�1 � a • ^'��O cerlily tlial on llie ��� 7 �
I(We) occupied as our principal place ol residence Ihe followiny described real propeily lor wliich a!-Iomeslead
Properly Tax Credil is hereby claimed: �f (We) owned ❑%1re buying under wntract
� I1ave a beneficial interesl in Ihe enlily Ilial is liable lor lhe property taxes on lhe properly and Ihal owns the
proper�y or is buying il under a conlracl.
CONTRACT RECORUED
If buying on conlract, Fee Simple Owner's Name
flecoider's ollice where coniracl is recoided
PROPERTY UESCRIPTIOIJ
' Taxing�I�isiricl (Cily, �own, lownship)
�Qe� urDeJ7/ 7' �I Legal Descriplion ��� �c �� 3- I I I• 136� t�
/ fo �J C..
II any porlion ol Ihe residenlial slrucWre or Ihe land nol exceeding one (1) acre Ihat irnmedialely surrounds Ihal slruc
lure is used to produce income describe Ihe use and porlion ol Ihe property ulilized lo produce income.
_ �il� �,� -'7'/il - /1/S � �i %-
PROPHRTY OW�dED BY CLAIMANT IN OTHER COUNTIES
ASSESSOfI USE OHLY TfiUE TAX VALUE ASSESSED VALUE IIOMESTEAD VALUE t70N-RESIDENIIAL
VALVE
Land nol exceeding t(one) acre immedialely
surrounding residenlial improvements ( � 1
Olherland (2)
Tolal la��d - line (t) plus line (2) (3)
fiesidential improvemenls Dweiling (4)
Garage (5)
Olher impwvemenls (6)
Total improvemenls • line (4) lhrough line (6) (7)
Tolal value - line (3) pius line (7) (8)
I hereby certify Ihe above is true, Signalure ol Assesor Date Signed
correct, and complete
Verilying Aclion - SignaWre oi �udilor Uate Signed
1989 Pay 1990
Lesser of 1/2 Homeslead
Valualion or $2,500
�
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991
Lesser of 1/2 1lornestead
Valualion or $2,000
1991 Pay 1992 19—Pay 19—
lesser ol 1/2 Flomeslead Lesser ol 1/2 Flomeslead
Valualion or $1,500 Valualion or $1,500
Signalure of Auditor / � ,,,n I D Je �'c
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