Homestead_Sellers�f n�p
ca °„ CLAIM FOR HOMESTEAD PROPERTY TAX
i��'= CREDIT/STANDARD DEDUCTION
�;,�� State Form Sa73 (R2 / 5-92)
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INSTRUCTIONS: See reverse side forliling instructions.
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�'f _., certity that on the 7st day of March, 79�
place of resi nce the following described reai property for which a Homestead Property Tax Credit is hereby claimed:
I(We) owned ❑ Are buying under contract - -
Have a beneticial interesi in ihe entity that is liable for the property taxes on ihe pmperty and that owns the property or is buying under a contract.
CONTRACT�RECORDED -
It buyirg on contract, Fee Simple owner's name .
Recorder's oftice where contract is retorded ReCOrd number Page
PROPERTY DESCRIPTION
Counry
Parcel number Legal tl ipiion ` '
O��-�ol8a�-oo �};� 1�( �( PIE 19-.3-�0 �� 3o�c
It any ponion of the residential svuaure or the land not exceeding one (7) acre that immetliatety surmunds that stmcmre is used ro produce income. descnbe Ne use arW portion
of the pmperry utilized to produce income. .
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PROPERTV OWNED BY CLAIMANT IN OTHER COUN'fIES -
County Township Couniy Township
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�eby certity the above statemenis are true, correct and Complete. Signacure of claimani �
Address (number and street ciry. stafe. ZIP code)
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ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately -
surrounding residential improvements. (�) �
Otherland (p) �
Total Iand (line 7 plus line 2� (3)
Dwelling (4)
Residential improvements
Garage (5)
Other improvements (6) � '
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line 7� (g)
I hereby cenify the above is tme, correct, and Si9nanre ot Assessor I oate signed-
complete.
Verifying acFOn - Signature ot Audimr Dare signed
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