Homestead_Johnson (5)�E'-'�� i CLAIM FOR HOMESTEAD PROPERTY TAX
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;��: CREDIT/STANDARD DEDUCTION
�;�� S�ate Form Se73 (R2 / 5-92)
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INSTRUCTIONS: See reverse side (or7iling instructions.
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� ' �nnna.suwrva�w��mcni .� . .
I�) . `�" . ceni(y�.pr�q t�da��1d�RQib? t9�
) occupied our principal place of re � ence�the following e ribed real property for which a Homesiead Property�����ereby Gaimed:
❑ I(We) owned ❑ Are buying under contract . � -
❑ Have a beneficial interest in the entiry that is liable tor ihe property taxes on ihe property and thai owns the property or is buying under a wntract.
- � . CONTRACTRECORDED � .--
IIf bv�ing on wntrad. Fee Simple owner's name .. � . �
Recorder's oHice where contract is recortletl Record number Page
Counry
PROPERTY DESCRIPTION
. Taxing di5fri�i (city. (Own,
Parcel number Legal deSCnp�i �
�� =a�aB �4- S� �-W � � - 3 - �7 i . � � c..:
li any portion of the residential struciure or the land not ecceeding one (7 � aae that immediately surrounds that structure is used ro produce income, descnhe Ne use and portion
ot the pmperty utiiized to produce income. ' ._ '
- /�-/a= .3nn -"DO/. `�d?�- D�
.ASSESSORUSEONLY TAUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VAIUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvemenis. (�) �
Oiherland (p)
Total land (line 1 p/us line Z� (3)
Dwelling (4)
Residential improvements
Garage (5) ,
Other improvements (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line 7� (g)
I hereby certify the above is lrue, correti, and Siqnawre ot Assessor Date signetl
�mplete.
�ng action - Signarore ot Autlitor Date signed
19_Pay79_
Lesser oi ll2 Homestead
Valuation or 52,000
STANDARD DEDUCTION ALLOWANCE
5
of Autlitor l � (� �� � I Dare signetl
t�l ��� � I-IC