Homestead_Michel (9)..•n•�4 CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
:� w; CREDIT/STANDARD DEDUCTI.ON Hcio � �
State Form 5473 (R2/1-90) �
.'� ,°�• �� INSTRUCTIONS: See reverse side (or liling instructions.
• CERTIFICATION STATEMENTD`� � OO �� / O �
I(We) � certify that on the 1st day of March , 19 �
!'We) occupied as o rinci I pl ce of residence t�he, /fol�,ewing described real property for which a Homestead
roperty Tax Credit is hereby claimed: L�J I(We) owned ❑ Are buying under contract
� Have a ben i i er �ntity that is liable for the property taxes on the property and that owns the
property or b� ontract.
�v�a�r ; ia90
If buying on coniract.
County
CONTRACT RECORDED
PROPERTY DESCRIPTION
Record Number
town,
Page
Parcel NumtlPr�� � Legal De p ion �� �� J/,� �O �
��7-6C�r �— t� � �iL -�v i�
If any portion of the residential structure or ihe land not exceeding one (t ) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township Countv Township
�—
hereby certify the above siatements are irue, correct and SignatUre �
complete.
Address (Street. number, city, siate and ZIP code)
ASSESSOR USE ONLV TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENiIAL
VALUE
Land not exceeding 1(one) acre immediately
surrounding resideniial improvemenis (�)
Oiherland (2)
Total land - line (7 ) plus line (2) (3)
Residential improvements Dwelling (4)
Garage (5)
Other improvemenis (6)
Total improvements - line (4) ihrough 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
Lesser of 1/2 Homestead
Valuation or $2,500
Signature
STANDARD DEDUCTION ALLOWANCE
7990 Pay 1991 1997 Pay 7992
Lesser of 1/2 Homestead Lesser of 7/2 Homestead
Valuation or $2.000 Valuation or $7,500
m
19—Pay 19—
Lesser of 1/2 Homestead
Valuation or $7,500
v.a