Homestead_Martin (4),.•—^—n
a1 >°„ CLAIM FOR HOMESTEAD PROPERTY TAX
} �;; CREDIT/STANDARD DEDUCTION
� State Form 5473 (R2 / S92)
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INSTRUCTIONS: See reverse side /or filing instructions.
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I �We) _ __, i- �/K.C� • _O,�i _ certify that on ihe 1st day���
�z) occupied as o rincipal place of residence .,e following described real property for which a Homesiead Property Tau Credit is hereby ciaimed:
�e) owned ❑ .Are buyinq under contract _
❑ Have a beneficiai interest in the entity that is liable for ihe pmperty taxes on the property and Ihai owns the property or is buying under a contraci.,
� �� � CONTRACT�RECORDED � . � � �
IIt buying on contract, Fee Simple owner's name .
Recorder's oflice where camraci is remrded " Recortl number Page
PROPERTY
County
Taxing di�str�c� (city. tovm. township)
Parcel number Legal � tion
�o�-o�o�a �- � n�� �-��rr I.�r�s
If any portion of the res'Wenual s�mcmre or the land not exceeding one (1) aue that immetliarety surmuntls ttiai structure is used to produce income. describe the use and ponion
oi ;he property u:ilizetl to produce inmme. �
PROPERTY OWNED BY CLAIMANT IN
TownShip Counry �
— � �
certity the above statemenis are ime, correci and complete.
srreef, ary, sfate, ZlPCOde)
S �UG�J
�THER COUNTIES
claimant
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately �
surrounding residential improvements. (�) •
Oiherland (2)
Total land (line 7 plus line Z� (3�
Dwelling (4)
Residential improvemenis
Garage (g) .
Other improvemenis � (6)
Total improvements (line 4 thiough line � �7)
Total value (line 3 p�s line � (g)
I hereby certify the above is true, correct, and Signature of Assessor Date signed
complete.
�tying attion - Signamre of Audimr Da:e signed
STANDARD
19_Pay79_
Lesserof 7/2 Homesiead
Valuation or 52.000
5
SignaWre ot Auditor �(\ t,, �^/� � va�p vgnea
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