Homestead_Powersd�p,, CLAIM FOR HOMESTEAD PROPERTY TAX
>'�"`'-� : CREDIT/STANDARD DEDUCTION -
� ' State Form 5473 (R2/1-90) - � " �
�' '°'• �� WSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT.
FORM YEAR
' HC10 �
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I(We) � �Jq. ',CF�!`2�'�S certify that on the 1 st day of March , 19�
''We) occupied as our p incipal place of residence the following described real property for which a Homestead
Property Tax Credit is heretiy claimed: � I(We) owned ❑; Are buying under contract
�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._ .
Ifbuying on contracL Fee Simple
Recorder's office where contract
T
�,
CONTRACT RECORDED
Name
�d
P_ROPERTY DESCRIPTION.
, Taxing Distri t C
:, T/l �q G
ripti
,,, , — a .- �, , � —d � � j—, , • ��� �� � =_� —/� , � �<<.
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to,produceincome describe the use and portion of the property utilized to produce income.
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PERTY OWIVED BY CLAIMANT IN OTHER COUNTIES
Township . ' County - , Township
e6y certify ihe above statemenis are Vue. correctand-: ignat e - .
plete. : . . • - . . �
ress (Street, number, city, te and ZIP cod )
-� ASSESSOR USE ONLY � �� TRUE TAX VAL'UE ASSESSED VALUE HOMESTEAD VALUE
NON-RESIDENTIAL
VALUE
Land not exceeding 1'(one) acre immediately '" '
surrounding residential improvements (�)
Otherland (2)
Total land - line (1) plus line (2) (3)
_ Residential improvements_ _ . Dwelling . (4)_ .
Garage (5)
Oiher improvemenis (6)
Total improvements - line (4) through 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
STANDARD DEDUCTION ALLOWANCE
1990 Pay 7991 7991 Pay 1992 79—Pay 19—
Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or �u2.000 Valuation or 57,500 Valuation or $1,500
of Auditor Date Signed
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