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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 .