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CREDIT/STANDARD DEDUCTION
State Form 5473_(R2/1-90)
INSTRUCTIONS.. See reverse side lor liling instructrons.
I . CERTIFICATION STATEMENT
FORM YEAR
HC10. Q
Do � . oo s-/o -ozs
I(we) C�—� Q�.l�–� Q.•!�v�--��. �� certity that on the 1st day ot March , 1s �Q
I(We) occupied as o pr+ncipal place of residence the following described real property for which a Homestead
��erty Tax Credit is hereby claimed: �, I(We) owned ❑ Are buying under contract
� Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
property or is buying it under a contract.
: � ;'.
on contracl. Fee Simple
Recorder's office where contraci is recorded
CONTRACT RECORDED
PROPERTY DESCRIPTION
_ Taxing Distri�
Record Number
town,
Page
Parcel Num�beor � � [7ESCn tio �aL( . 3� 3 t�L
�O`�7" .5� � ��� �-3- ��
I( any poriion o( the resideniial structure or the land noi exceeding one (1) acre ihat immediately surrounds ihat siruc-
ture is used to produce income describe the use and portion of the properiy utilized to produce income.
o�G - /d�- o?� /�o - /JDO. S �o - Gas -
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY � � TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON•RESIDENTIAL
. VALUE
Landnotexceeding 1(one)acreimmediately
surrounding resideNial improvemenis (�)
Olherland ���� (2)
Total land - ( (3)
Fesiden�ialimprovement �Dwelling (4)
MAY � 1990�a�a9e (s)
Other im ro menis � � (6)
Total impr vement��f��}Zh�line (6) (7)
Total value - line (3) plus line (7)� (8) �
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
�1989 Pay 1990
asser o( 1/2 Homestead
Valuation or $2,500
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991
..Lesser oi 1/2 Homestead
�.;; � Valuation or $2,000
��;; ';
1991 Pay 1992
Lesser of 1/2 Homestead
Valualion or $1,500
19—Pay 19—
Lesser of 1/2 Homestead
Valuation or $1,500
of Auditor �� i " "
�� . �n .. _ . � - �l O