Homestead_Spindler (11)ST11p
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION �
State Fortn 5473 (R2 / S92)
FORM
HC70
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YEAR
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INSTRUCTIONS: See reverse side lor liling instructions. p �r
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/� CERTIFICATION STATEMENT
I(VJe) / certify thA�j t118 Yst tlay of March,
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I(We) xcupied as our principal place of re denc the following described real property for which a Homestead Property Tax Cred is here i ed:
❑ I(We) owned ❑ Are buying under coniract r �Q�jOF
❑ Have a beneficial interest idthe entiry that is liable for the property taues on the property and thai owns the� G`�SONi� }►eSg�Lr�er a contract.
CONTRACT RECORDED � `
If buying on contrect, Fee Simple owners name
Recortlers office where conUact is recorded Fecord number Page
PROPERTY DESCRIPTION
Counry /�� � Township � � Taring disMCt (ciry, t township)
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Parcel numbe� Legal description
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t any portion of Ne residential structure w the tand not ezceeding one (i) acre ihat immetliarety sunountls thai structure is used to produce income, tlescribe the use antl portion ot
the property uf�d of�pp���ome.
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PROPERTY OWNED BV CLAIMANT IN OTHER COUNTRIES
Counry Tovmship Counry Township
Signawre ot daimant
.ereby certify the above statements are true, correct and complete. A
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Address (number and streel, ary, sfafe, ZIP codeJ '
/ek 3 !3 x Z2Z Owe�sv:/1 =N �� (ob5
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE � VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately (�)
surrounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (a)
Residential improvements .
Garage (5)
Oiher improvements (6)
Total improvements (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true. correct, and Signature of Assesor Date signed
complete. -
Venlying action - SgnaWre of Auditor Date signed
� STANDARD DEDUCTION ALLOWANCE
9 Pa 19 _
sser � /2 Homestead S
V I ation o 52,000
Sgnature of Auditor Date signed
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