Homestead_Heldt (11)e��"�°, CLAIM FOR HOMESTEAD PROPERTY`TAX �
;��� CREDIT/STANDARD DEDUCTION _
�,;��� State Form Sa73 (R2 / 5-92)
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.. INSTRUCTIONS�See reverse side lor filing instructions.
CERTIFICATION�STATEMENT - -
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I �We) II�G V l.- `(.XJL(J��l � . �. .��.. �,- � �- certify.ihat on ihe 7st day of March, 79�
.e) occupi as our principal place of residence the following tlescribedieal property for which a Homestead Property Tax Credit is hereby Gaimed:
� I (We) owned ❑ Are buying under coniract , � , , �, -
❑ Have a beneficiai interest in the entiry that is Iiabie tor the property taxes on the property and thai owns the property or is buying under a wntrect.
� CONTRACT RECORDED � � . - �
If buying on contraa,.Fee Simple owner's name . _ .
Recorder's oHice where comrac� is recorded Rewrd number Page
Counry I I TownsNp �� I Taxing dsUict (pry,Yrnvn, rownshlp) , _
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Parcel number Legal tlescripti
���=00�03-0o p+ -� `/2 Sw a9-3-►0 �.�gSa,�
tl any portion ot the residential simcture or the lantl not exceetling one �1) acre that immediately surwunds that strucNre is used m protluce income, describe ihe use and portion
ot the property utilized to produce income.
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� ASSESSOR USE ONLY - TRUE TAJC ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvements. (�)
Other land - (p) .
Total land (line 1 plus line 2� �3) �
Dwelling (4)
Residential improvements
Garage (5)
Other improvements (6)
7otal improvements Qine a through line � (7) I
7otal value (line 3 pLs line � . (g)
I hereby Certify Ihe above i5 irue. Correct, and Signawre ot Assesmr Date signed
complete.
oritying action - Signature of Audimr Date signed
19_Pay79_
Lesser of 1/2 Homestead
valuation or $2.000
STANDARD DEDUCTION
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of Audilor / / / � � .-. ' � Date