Homestead_Raineye�% �'� ; CLAIM FOR HOMESTEAD PROPERTY TAX
i��'� CREDIT/STl;NDARDDEDUCTION
�.,�'� State Form Sa73 (R2 / 5-92)
,.i . .
INSTRUCTIONS: See �everse side !or filing instructions.
FORM YEAR
HC10 �
' ' TIPICATION STATEMENT � � ' � ' � - -
��W - certify that on the 1 da f arL
�) occupied as our pri ipal place of residence th � f lowing de cribed real prop tor which a Homestead Pmperty Tax C reby aimed:
��' I(We) owned ❑ Are buyinq under contract �� ft�997 "
❑ Have a beneficial interesi in ihe entity thai is liable for the property taxes on the property and ihat owns the property�s buying un�er �ybntraci.,
It buying on contraci, Fee Simple owner's name
Recorder's oHice where contraci is recorded
Couniy
P�r 1 er_(�
J �
If any porti0n of the ri
of the properry udlize
Counry
CONTRACTRECORDED
Record number
Page
-� PROPEPTY DESCRIPTION �
' - TownShip � ' ' - Tauing district iry4 own, fownshrp) - �
/�\�
/�(�/(�� L�egal description �
�"�_J
sirucwre or the IaM not exceeding one (7) acre ihat immediatety surrounds that structure is used to produce income, tlescnbe the use and portion
ice income.
r••�(XJ—UCJ/_ /Oti–vold
PPOPERTY OWNED BY CLAIMANT IN OTFiER COUNTIES
certify the above siatemenis are true, correct and complete.
(numberarMSbeet.ciry,s(ate,ZlPcode) ,
�� ASSESSOR USE ONLY : TRUE TAX , ASSESSED � HOMESTEAD NON-RESIDENTIAL �
VALUE VALUE. VALUE VAWE
Land not exceeding 1(one) acre immediately - - .
surrounding resideniial improvements. (�) �
Oiherland (2) � _
Total land (line 7 p/us line � (3)
Dwelling (4) - �
Residential improvemenis
Garage (5)
Other improvements (6)
Total improvements (line 4 through line � (7)
Total value (line 3 pbs line 7) (g)
I hereby Certify the above is true, CorreCi, and Siqnature oi Assessor Date signed
complete.
�Ning action - Signamre of Audiror . . Dare signetl
I
" - STANDARD DEDUCTION ALIOWANCE � - - � -
19_Pay79_
Lesser of 7l2 Homestead �
Valuation or 52.000 S .
SgnaWre of Autlitor Da:e signetl