Homestead_Smith (5)dr-•�•4 CLAIM FOR HOMESTEAD PROPERTY TAX FoRM reaR �� - ' CREDIT/STANDARD DEDUCTION. , Hcio � .. ..- y � State Form 5473 (R2/1-90) � �' '°�• �� INSTRUCTIONS: See reverse side lor liling instructions. . _ CERTIFICATION STATEMENT i I(We) �� ;�n�ti certify that on the 1st day of March ,�19 � I(We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed: �We) ow.ned ❑ 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. CONTRACT.RECORDED ' If buying on contract. Fee Simple Owner's Name Recorder's office where contract County • P c I�� If any portio�� ture is c ` � . - 01 County `� I hereby certify the a PROPERTY DESCRIPTION T township) . � • - �. ;-��Legal ripti $.31 � C� -� �. '�0-3- lo sidential structure or the land not exceeding one (1) acre thai immediately surrounds that struc- '�ncome describe the use and portion of the property utilized to produce income. ` /- - - ' - siirin PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES Township County • . T statemenis are true. correci and Iress (Street. number, city. state and ZIP code) ' " �- ' ' O E S �fFl N � �� � ASSESSOR USE ONLY � TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE r vnwe Land not exceeding t(one) acre immediately surrounding residential improvemenis (�) Otherland (2) Total land - line (1) plus line (2) (3) Residential improvements Dwelling - (4)� -- - � � � - - - � - Garage (5) Other improvements (6) Total improvemenis - line (4) lhrough 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 7990 Lesser of 1 /2 Homestead Valuation or $2.500 Signature of Auditor STANDARD DEDUCTION ALLOWANCE 1990 Pay 1991 Lesser of 1/2 Homestead Valuation or S2.000 � 1991 Pay 7992 79_Pay 19— Lesser of 1/2 Homestead Lesser of t/2 Homestead Valuation or 57,500 Valuation or �7,500 Date �- �