Homestead_Halle% '•�' .
a °4 CLAIM FOR HOMESTEAD PROPERTY TAX, FoRM YEA�
s��'� CREDITISTANDARD DEDUCTION riCio
.�.;�� State�FOrm5a73�R2/5-92)
INSTRUCTIONS: See reverse side !or liling insfructions.
� � C TIFICA?ION STATEMENT .. � -
I(W �F ` certify that on the 1st day of March, 79_
I( e) occupied as o rincipal place of residence ihe tollowing de ribed real property for which a Homestead Property Tax Credit is hereby claimed:
I(We) owned ❑ Are buying under contract .,. � �
Have a beneficial interesi in the eMiry ihat is liable for the property taxes on ihe property and thai owns ihe pmperty or is buying under a contraci.
.CONTRACT RECORDED (,�V �r- ��] �7� .
I� brying on tontraC6 Fee Simple owners name � • �� ��
Recordefs oftice where contract is recorded Record nu�i tI�P� 2�'�Q Pdge
n. ,�
� - � PROPERTY DESCRIP'fION `"� " „� �'v' °r
Count Township - Tazingdis[rict�ci, wn,fownship) nvv��vi
� Parcel number Legal de5ctiption
o -(� 5-0 � �- 3-io -�-
It any portion ot the residential stmcture or the Iand noi exceetling one (1) acre that �mmetliate surtountls that structure is used to produce income, deuribe the use antl portion
ot the properry u6lized ro produce income. �
cr� - -(� % O - OGO. �?oS o?oS
County
PROPERTY OWNED BY CLAIMANT IN
o Counry
I hereby certify the above statements are true, correct and complete.
(number arM street ciry. stafe. ZIP crode)
� ASSESSOR USE ONLY � �� TRUE TAX • � ASSESSED HOMESTEAD NON-RESIDENTIAL �
� VALUE VALUE VALUE � VALUE �
Land not exceeding 7(one) acre immediately
surrounding residential improvements. (�) -� �
IOiherland (p) �
Total land (line 1 plus line 2� (3) .
Dwelling (a)
Residential improvements
Garage (5) � �
Other improvements (6)
Total improvements Qine 4[hrough line � (7)
Total value (line 3 p�s line 7� (g)
I hereby certify the above is Uue, corrett, and SignaNre of Asseswr Date signed
complere.
Veritying action - Signature ot Auditor Date signed
STANDARD DEDUCTION ALIOWANCE � �
— 19_Pay19_
Lesser of 1/2 Homestead
Valuation or 52,000 S
Signature ot Auditor Dare signed