Homestead_Pauld..��•,t CLAIM FOR HOMESTEAD PROPERTY TAX
�;'"" � ; CREDIT/STANDARD'DEDUCTION �—
:� State Form 5473 (R2/1-90)
�'°�• � INSTRUCTIONS: See reverse side (or liling instructions.
FORM
HC10
O/� %9
CERTIFICATION STATEMENT O � -DD
I(We) �y� d-�'�,(,Q�. 1 Q� certify that on the 1st day of March , 19 �
�We) occupied as our principal place of residence �th...e/ following described real property for which a Homestead
Property Taz Credit is hereby claimed: �� LXf I(We) owned - ❑ Are buying under contract
r�
� Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
property or is buying•it under a contract.
_ CONTRACT RECORDED o a
on contract. Fee Simple Owner's Name
Recorder's office where contract is recorded
County
�egal
a2'-/'r�-�� � 7
�TY DESCRIPTION
� _Taxing District (C
-C�/. ?9-
Record �n'b'
town,
, �,-
� X> [ - HC-TTT`vv I r i . �c,-r� �. � � __� -�' v ,�o ,7�L' �
If any portion of the residential struciure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income descritie the use and portion of the property utilized to produce income.
PFtOPERTY OWNED BY CLAI
�
certify ihe above statements are irue. correci and
Address (Street, nu
• - •
. .
ii L.� ��i._ _�
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_ .-_ � .- t .
ASSESSOR USE ONLV •- TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENiIAL
- VALUE
Land not exceeding 7(one) acre immediately ..
surrounding residential improvements (�)
Oiherland (2)
Total land - line (7) plus line (2) (3)
Residential improvemenis . _Dwelling (4) .
Garage (5)
Oiher improvemenis (6)
To[al improvements - line (4) through line (6) (7)
Total value - line (3) ptus 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
STANDARD DEDUCTION ALLOWANCE
1989 Pay 7990 1990 Pay 1997 1991 Pay 1992 79—Pay 19—
Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser o( 7/2 Homestead Lesser of 1/2 Homestead
Valuation or $2,500 Valuation or $2,000 Valuation or $1,500 Valuation or $7,500
Signature of Audij6r� `�� �,�, � � Date� Sig