Homestead_Gries�.E•T•� CLAIM FOR HOMESTEAD RROPERTY TAX
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31-"__ � ; CREDIT/STANDARD DEDUCTION
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� State Form 5473 (R2/1-90)
`' '°�• `� INSTRUCTIONS: See reve�se side for filing instructions.
CERTIFICATION STATEMENT DD
FORM YEAR
HC10
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�(We) v���QU �. °E- LdL.t7/1 I�) • certify that on the 1st day of March , 19 �
(We) occupied as our principal place of residence the following described real property for which a Homestead
Property Tax Credit is hereby daimed: �� '� I(We) owned .❑ Are buying under contract
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� Have a beneficial interest in the entity that is liable forthe property taxes on the property and that owns the
property or is buying it under a contract.
_ - . - . ��'�° �,�
CONTRACT RECORDED -
If buying on contract,
order's office where contract is recorded •
.. �FRORERTY DESCRIPTION
nty � � � , Town�t]ip • ` Taxing i trict (
AUG O y
Number' "
P�rceol� mb�r o�_ Legal Descripiion n� C��/� •. -
(] � I � f d .3Q-3—�� ���(i
If.any portion of the residential struciure-or the land not exceeding one (1) acre that immediately surrounds that struc-. ,
ture is used to Produce income describe the use and portion of the Property utilized to produce income.
nty
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PROPERTY OWNED BY•CLAIMANT IN OTHER COUNTIES
Township . - _ County - • _
hereby certify the above statemenis are true. correcCand '
ASSESSOR USE ONLY
TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
� • • - VALUE
Land not exceeding 7(one) acre immediately �-
surrounding residential improvements ��)
Oiherland (2)
Total land - line (7) plus line (2) (3)
� ResideniiaPimprovements - - �Dwelling (4)- � � - �- - - - - - - - - � -
Garage (5)
Other improvements (6)
Total improvements - line (4) through line (6) (7)
Total value - Iine (3) plus line (7) (8)
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990 1990 Pay 1991 1991 Pay 1992 19 — Pay 19—
Lesser of 7/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or $2,500 Valuation or $2,000 Valuation or $1,500 Valuation or $7,500
Signature of Auditor
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