Homestead_Kohla� ^"n . CLAIM FOR HOMESTEAD PROPERTY TAX FORM
;��� CREDITISTANDARDDEDUCTION ���..,d.�� HCio �3R
.�,';� Stare Form Sa73 (R2 / 5-92) �
,��. JAN 21 1�93
INSTRUCTIONS: See reverse side 7or /iling inshuctiona � �
I(We) /�/WYl.l4X L(/ •'d' V�'� S�U- iC 6�X_i certify that on the 7 st day oi March. 79�
I(We) occupied as our principal place of residence the.following described real pmperty.for which a Homestead Property Tax Credit is hereby daimed
� I (We) owned ❑ Are buying under con�ract � . � � .
Have a beneficial inieresi in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
i
CONTRACT RECORDED �
tl Wying on contract Fee Simple owner's name • � .
Recorder's oNite where contract is recortled Record number Page
County
Pa�rcel �n�umber�
b�_1—_
If any portion o
ol Ne property
PROPERTY DESCRIPTION
fown,
I Legal tles,\ . � � ,^ � _f' ' .&i � \�
I .t
r-•
stmcmre or the land not exceeding one (7 ) acre Ihat immediatey surmunds that SlrucNre is used ro protluce income, tlescribe Ne use and ponion
ce income.
- PROPERTY OWNED BY CLAIMANT IN C
County Township Cauniy
_��
I hereby certify the above statements are irue, correci and complete. Signamre o�
sbeef,
sN
COUNTIES
� ASSESSOR USE ONLY . � TRUE TAX � ASSESSED HOMESTEAD NON-RESIDENTIAL
� � .VALUE VALUE VALUE . VALUE
Land not exceeding 1(one) acre immediately .
surtounding residential improvemenis. (�) '
Other land (p) -
Total Iand (line 1 plus line Z� (3)
Dwelling (4) �
Residential improvements -
Garage (g) -
Other improvements (6) � �
Total improvements (line 4 fhrough line � (7) -
Total value pine 3 p6s line 7� (g)
I hereby certify ihe above is Irue, correct. and Signamre of Assessor Date signed
complete.
Verifying aaion - Si9namre ot Auditor Dare signed
� STANDARD�DEDUCTION ALLOWANCE '
" 19_Pay19_
Lesser of 7/2 Homestead .
Valuation or 52,000 �
Signature of Audi;or . Date signed
�. _ai-93