Homestead_Saleed.��•�,s CLAIM FOR HOMESTEAD PROPERTY TAX, FoRM YEAR
s. �-,, CREDIT/STANDARD DEDUCTION -� - Hcio qO
State Form 5473 (R2/1-90)
`' '°�• �� INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT•
I(We) ��_ _ � certify that on the 1 st day of March�, 19 �
�We) occupied as our prin al place of residence t,�he, �following described real property for which a Homestead
Froperty Tax Credit is hereby claimed: L1� I(We) owned ❑ Are buying under contract
Have a beneiicial interest in the entity that is liable for the propertytaxes on the property and that owns the
� orone�a:asd�b�.vina:t�ander a contract.
on contract�
CONTRACT RECORDED
Owner's Name ,
is recorded -
PERTY DESCRIPTION
Record Number -
town,
Page.
�P���/`r�� ��� g' I mI(`' I Legal Description Q� �� � � I—�_ � O ,�� �
`� VI C��/ I
If any portion of the residential structure or the land not exceeding one (7 ).acre that immediately surrounds that siruc-
ture is used to produce income describe the use and portion of the property utilized to p�oduce income.
�/_ �9_//- �i-Gao• d�85� 6�S
" PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Township
certifylhe above statements are irue, correct and
Address (Street, number. city, state
ASSESSOR USE ONLY
m
TRUE TAX VALUE � ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
- VALUE
Landnotexceeding7�(one)acreimmediately � - ��
surrounding resideniial improvements (� 1
Otherland (2)
Total land - fine (t ) plus line (2) (3)
Residen[ial improvements _ Dwelling . (4) . . .
Garage (5)
Other improvements (6)
Total improvemenis - line (4) �hrough line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify ihe above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature o( Auditor Date Signed
1989 Pay 1990
Lesser of 1/2 Homestead
Valuation or $2,500
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991
Lesser of 1/2 Homestead
Vaivation or $2.000
��
1991 Pay 7 992 19 — Pay 19 —
Lesser of 7/2 Homestead Lesser ot 1/2 Homestead
Valuation or $1,500 Valuation or �1,500
Signature of Aud or Uate Signe
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