Homestead_Hulfachore!^��' i CLAIM FOR HOMESTEAD PROPERTY TAX � PoRM YEAR
`� - 9 !° CREDIT/STAkDARD DEDUCTION , HC�o �
s`'
�;;� State Fortn Sd73 (R2 / 5-92) �
In• . . . . . . . .
. INSTRUC710N5: See reverse side !or (iling instructions. -
i�we) �� certify.thai on�the 1st day of March, 19
�) occu ' as our principal g described reai ro erty for which a Homestead Property Ta�c Credit is hereby daimed:
(We)owned ❑ Arebuyingundercontract -� � � , • �. , �i"������
tse •
❑ Have a beneficial interest in the emity thai is liable for the property taxes on the property and thai owns the pmperty or�DUy g d r ei
If buyirg on coniract, Fee Simple owner's name
Recorder's oHice where contract is reCOrded
County
a r
1 _
If any portion of th re idential.
of Ne property utilized ta prOdu
�
County _
CONTRACT RECORDED
� � _ .�
��_��i�itse
' PROPERTY DESCRIPTIO '
� Township - Taxingdistri (c , wn,tdwnshipp� �
1 Legal deuription . _
�
l or the land not exceetling one (7� acre ihat immediately surmunds ihat 5trucNre is used to produce income, descnGe the use and portion
ne.
;/D —017 = /U/ � w/ . 7/7 � ��1 V
PHOPERTY OWNED BV CLAIMANT IN OTHER COUNTIES
� certify the above siatements are irue, correa and complete.
(number arW slree(, city, state. Z1P wde) �, �
ASSESSOR USE ONLY
Land not exceeding 7(one) acre immediately
surrounding residentiat improvements.
Oiherland
Total land (line 1 plus line Z�
Dwelling
Residential improvemenis
Garage
Other improvements
Totai improvements (line 4 through line �
Total value (line 3 p�s line �
I hereby cenify ihe above is true. correci, and
complete.
�ing action - Signature of Auditor
TRUE TAX
VALUE
(U
(Z)
(3)
(4)
(5)
(6)
l�)
(8)
Signature of Assessor
of claimant
ASSESSED
VALUE
19_Pay19_
Lesser of 7/2 Homestead � ,
Valuation or 52,000 S �
HOMESTEAD
VALUE
NON-RESIDENTIAL
VAWE
Dare si9netl
Date signed