Homestead_Ghantae�/ "�� g CLAIM FOR HOMESTEAD PROPERTY TAX FoRM YEAR .
���' CREDIT/STtiNDARD DEDUCTION HC�O = �
� State Form Sd73 (R2 / 592)
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INSTRUCTIONS: See ieverse side for liling instructiona �
�- - - � - �c -' � �' � CERTIFICATION$TAT ENT'` - � - � -
I(We) � ertify�that on thetlls'day of Marc , 9_
I(We) occupied as our princi place of residence the following described real.property tor which a Homestead PropertiuTwo Crydit is4�ereby claimed:
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I� I(We) owned ❑ Arebuying under contract -. • - � //
�-lave a beneficial interest in the entity that is liable for ihe property taxes on the property and ihat owns the perty or is`b+yying�nder a tr
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" 6l - + �+t'" . '�ITOR
� .- � . CONTRACT RECORDED - � - � � � . �
Ii buying on contratt, Fee Simple owner's name � . ". � '
Fecorder's office where coniraa is recorded Record number Page
� � - PROPERTY DESCRIPTION � �
County - � . Township � " Taxirg districi (dry.�town. fownship) _
P rcel nu ber— �� Leqal tlescriptio I �� �
�
Ii any portion of the residential stmcture or the IarM rwt exce ng one (7) aue that immediatey surrounds that structure is used to produce income, desenb the use antl portion
of the properry utilized ta produce income.
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PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES - '
County Township Couniy . Township
1 hereby certify ihe above statements are irue, correct and comp�ete. Signa� e � aa ani t � .
�ess (number and sbeel. ury, state. ZlPCOde)
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ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL -
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediatety .
surrounding residential improvemenis. (�) �
Otherland (p� �
7otal land (line 7 plus line 2� (3)
Dwelling (4) � �
Residential improvemenis - .
Garage (5) .
Other improvements (6)
Total improvemenis (line 4 through line � (7) '
Total value (line 3 p�s line � (g) _
I hereby certify ihe above is irue, correGi, and Sgnamre of Assessor Dare signed -
. complete.
Verityirg action - SignaWre of Autlitor . Date 5igned