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Homestead_Neufelderj'`''"'° - CLAIM FOR HOMESTEAD PROPERTY TAX ` ° CREDIT/STANDARD DEDUCTION � ;, Sta[e Fofm 5473 (R2 / S92) - '��� INSTRUCTIONS: See reverse side /or /iling instructions. FORM HC70 YEAR � CERTIFICATION STATEMENT I(We) ce tha i 7 d ch, _ I(We) occupied as our principa lace of residence the tollowing describ reat property for which a Homestead Property Tax Credit is e imed: ❑ I(We) owned ❑ Are buying under contract SEP 13 2000 ❑ Have a beneficial interest in the eniity that is liable for ihe property taxes on the property and that owns th perty or is buyin nder a contract. CONTRACT RECORDED GIBSON C If buying on contrect, Fee Simple owners name Recortler's of(we where contrad is recorded Record number Page PROPERTY DESCRIPTION Counry Township Tazing district (rary, town, rownship) Parcel number LegalOescrip' -E�?c�• o t Ss� 3- - 1 . s� L any ponion of the resitlentlal sirucW re or ihe land not exceeding one (1) acre that immediatety sunountls ihat swcture is used to produce income, descnbe Ne use antl poNOn of the pmperry uGlizetl ro protluce income. �-/2- 3- s-a� ��a-oas PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES Counry TownShip Counry Township I Sig tur fcla nt sreby certify the above statements are true, correct and complete. Address (number antl stree(, ciry, sla(e, ZIP code) !�v K 7 .�H. �� 6 s� ASSESSOR USE ONLY TRUE 7AX ASSESSED HOMESTEAD NON-RESIDENTIAL VALUE VALUE VALUE VALUE Land nof exceeding 1(one) acre immediatety ��� surtounding residential improvements. Otherland (2) Total land (line 7 plus line 2) (3) Dwelling (4) . Residential improvements Garage (5) Oiher improvements (6) . � Total improvemenis (line 4 fhrough line 6J (7) Total value (line 3 plus line 7) (8) . I hereby certify Ihe above is Irue, CArreCt, and Signature of Assesor Date signetl wmplete. Veritying action - Signature ol Auditor Date signed � STANDARD DEDUCTION ALLOWANCE 19_ Pay 19 _ Lesser of 1/2 Homestead S Valuation or 52.000 Siqnature of Auditor � Date signed q- 3 -ao