Homestead_Smith (5)dr-•�•4 CLAIM FOR HOMESTEAD PROPERTY TAX FoRM reaR
�� - ' CREDIT/STANDARD DEDUCTION. , Hcio �
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� State Form 5473 (R2/1-90) � �'
'°�• �� INSTRUCTIONS: See reverse side lor liling instructions. . _
CERTIFICATION STATEMENT
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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 •
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If any portio��
ture is c
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County `�
I hereby certify the a
PROPERTY DESCRIPTION
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township) .
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;-��Legal ripti $.31 � C�
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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.
` /- - - ' -
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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 � ��
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ASSESSOR USE ONLY � TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
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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
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