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Homestead_Taylor (3), ,,,,, - - �� i CLAIM FOR HOMESTEAD PROPERTY TAX - ���= CREDITISTANDARD DEDUCTION .�.,;� State Form 5473 (R2 / 5-92) �eu . . . INSTRUCTIONS: See reverse side !or liling instructions. ' � - - CERTIFICATION STATEMENT ' � !� •i � i �.� � _ �1�� 21 19�5 L �E 7� CL.� /�p �1 � ) _ L� ��y certify that on. 'sf March, 79 �) occupied as our principal place oi residence the following describe r al property for�which a Homestead Property Tax Credit is hereby claimed: � I (We) owned ❑ Are buying under contract, . � . _ . ❑ Have a beneticial interest in.the entity that is liable for the property taxes on the property and ihat owns the property or is buying under a contrect. �CONTRACT RECORDED � � � - I( buying on contrect, Fee Simple owner's name �• , Recorder's oNice where contract is recortled Recortl number Page ' PROPERTY DESCHIPTION Township . Tacing tlistri ( fo-.vn, townshrp) S o �✓ G���c� Pareel numher Leg I r tion �0%�`7�75L ��' �� 0�1�= 3-// /,�� QG It any portion of ihe residential stmcture or the land not exceedinq one (1) acre that immediatety surrounds that swaure is used to protluce income, tlescribe Ne use and ponion of ihe property uulized ro produce income. — / !I —olCo � QUU — (�Y1 PROPERTV OWNED BY Township certify ihe above statements are true, correct and complete. �number ndstreef. ciry, sfafe. ZlPCode) .(Z.�( �� 4 5 4 � �t.� MANT IN OTHER County Sgnature of iman ASSESSOR USE ONLY . TRUE TAX� ASSESSED HOMESTEAD NON-RESIDENTIAL - VALUE VALUE VALUE VALUE Land not exceeding 7(one) acre immediately surrounding residential improvements. (�) ' Oiherland (p) Total land (line 7 plus line 2� (3) I Dwelling (4) � - Residential improvements Garage (5� Oiher improvements (6) - Total improvements (line 4 through line � (7) Total value (line 3 p6s line 7) (g) I hereby ceRify the above is true, correct, and Signamre ol Assessor Date signed complete. �drg action - Signature ot Audi;or Date signed 19_Pay19_ Lesser of t/2 Homestead Valuation or 52,000 E �reOlAudi:o! � Iva�e>ynev .