Homestead_Kiesel (9)a%���`4� CLAIM FOR HOMESTEAO PROPERTY TAX
i,E�': CREDIT/STANDARD DEDUCTION
�.�;�� State Form Sa73 (R2 / 5-92�
uu ,
INSTRUCTIONS: See ieverse side lor filing instmctions.
. - ' . CERTIFICATION STATEMENT - �
i�We) �/1R� T'� �J � � nnc� L K� e s..e.1 certify
�) occupied as our principal place of residence the following described real property for which a Homestead
❑ I(We) owned ❑ Are buying under contract -
❑ Have a beneficiai interest in ihe entiry ihat is liable tor the propeny tazes on the property and thai owns ihe F
CONTRACTRECORDED
If buying on convau, Fee Simple owner's name
ReCOrder's oftice where contract is recorded
FORM
HC70
YEAR
� Tez Credit is hereby claimed:
=C 2 3 .1996
or is buyinq under a contract.
number � Page
� � ` PROPERTY DESCRIPTION � -
Counry Town$hip .� • Tazirg tlisuict (ciry, town, fownship)
l� 1 O Yl
Parcel number descnption
oon-oil�c� -oc� �+ ur: ds 3 li 3. ��a �
If any portion of the resitlential swcwre or the land not exceeding one (7) aae ihat immediate�y surrounds that struciure is used to produce irkome, descnbe the use and portion
ot ihe property uti6zed m produce inmme. _ ,
�i �w.siiiic
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL -
- VAIUE VALUE VALUE . VALUE
Land not exceeding t(one) acre immediately
surroundinq residential improvements. (�� � ' '
Otherland (p) �
Tmal land (line 7 plus line 2� (3)
Dwelling (4)
ResideMial impmvements
� Garage (g) - -
Oiher improvemenis (6)
Total improvements (line 4 through line � (7) ,
Total value (line 3 p�s line 7� (g)
I hereby tehify the above is true, corrett, and � Signature of Assessor Oate signed
complete.
��Mrg aaion - SignaWre of Auditor Date signetl
I�
STANDARD DEDUCTION ALCOWANCE
19_Pay19_
Lesser of tl2 Homesiead .
Valuation or $2,000 S