Homestead_RiedfordeE/'�� � CLAIM FOR HOMESTEAD PROPERTY TAX FORM � YEAR
;r�' CREDIT/STAI�DARD DEDUCTION ,�q HCio
�r State Form Sa73 (R2 / 5-92) � g ,,
=' �yyQ']
��i• . � ��R�
INSTRUCTIONS: See reverse side lor (iling instructions.
0
I(We)���k_ vy�� �P:, - c� y th t h 1st day of March, 19_
.'e) occupied as our principal place of residence the following described r I property r� ' � A��jqT Credit is hereby Gaimed:
��� ou
IJ I(We) owned ❑ Are buying under coniract . �
❑ Have a beneficial interest in ihe entity ihat is liable for the propeny taxes on ihe property and thai owns ihe property or is buying under a contraci.
� � . CONTRACTRECORDED, � . - - - �'
It bupng on contract, Fee Simple owner's name ' �
ReCOrder's ottice where contract is recorded Recortl number Pa9e
- ° � PROPERTY DESCRIPTION
Counry ^ . � 7ownship TaziM1� dis(rici (ciJy fown, fo1 ship)
/ , n c ,-. � 1
Parcel number Legal tlescription
��-��410 . .
If any portion of the res�dential structure or the land not exceeding one (7) aae that immediatety surrounds that strucNre is used to produce income, describe ihe use antl ponion
ot ihe property utilized to produce income. ,_
.�� -/�' �9- �o -aa/. 9ro -o��-
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvements. (�) �
Other land (p) .
Total land (line 1 plus line Z� (3) I
Dwelling (4) � -
Resideniial improvements
Garege (g) 1�
IOiher improvemenis (6)
Total improvemenis (line 4 through line � (7)
Total value (line 3 p�s line 7) (g)
I hereby certity the above is Irue, GorreCt, and Sgnature of Assessor Date signed
complete.
�fying aMion - Signature of Audimr � Date signed
. STANDARD DEDUCTION ALLOWANCE
19_Pay19_ �
. Lesser of 7/2 Homestead � �
Valuation or 52.000 S
SignaNre of Audimr Date si9ned