Homestead_Lindauer (3)eE �'�� a CLAIM FOR HOMESTEAD PROPERTY TAX
i��'= CREDIT/STANDARD DEDUCTION
.,��.%� State Form 5a73 (R2 / 5-92)
INSTRUCTIONS: See ieverse side lor tiling instructions.
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HC10
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I (We) �.= � � e � . 1 �� � \ ��s� I � ° "� �'�' rt' �-- certify.that on the 7st day of March, 79_
"We)-occupied as our principal place of resi ence the following described re I.property for which a Homestead Property Ta�c Credit is hereby claimed:
�I (We) owned ❑ Are buying under contract -
Have a beneficial interest in the entity ihat is liable for ihe property taxes on the property and ihat owns the property or is buying under a contract.
. . CONTRACT RECORDED -
It buying on contraa. Fee Simple owners name �
Recorder's oHice where contrect is recortled . Recortl number Page
Caunry
Township
PROPERTY DESCRIPTION
fown,
Parcel number Legal descri ,io
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tl any ponion ot the residential sirudure or the la(W not exceetling one (1) acre that immetliatey surrountls that struciure is used ro
of the pmperry utilized to produce income.
�?G-/9-�� - .sa� - �ao. �//- Q�s
income, describe Ne u5e and portion
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDEN'fIAL
.;VALUE - VALUE VALUE VALUE �
Land noi exceeding 7(one) acre immediately
surrounding residential improvemenis. (�)
Otherland (p� ,
Total land (line 7 plus line 2� (3�
Dwelling (4) �
Residential improvements
Garage (5)
Oiher improvements (6)
Total improvemenis (line 4 through line � (7)
Total value (line 3 p�s line � (g)
I hereby ceRify ihe above is irue. correct, and Signamre of Assessor Dare signed
complete.
Veritying action - Signature of Autlitor Date si9netl
19_Pay19_
Lesser of 1/2 Homestead
Valuation or 52.000
DEDUCTIONALLOWANCE
S
Dare signed
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