HomeMy WebLinkAboutHomestead_Hurt (2)CLAIM FOR HOMESTEAD PROPERTY TAX DG FORM
CREDIT/STANDARD DEDUCTION Hcto
Slate Form 5473 (R6 / 403)
Resorbed by the Department of local Government Fm
INSTRUCTIONS: See revorw sbe for Il3rp %efbtl dom
YEAR .®
I (We) �[ / X- }'[/If _J -.rG(y gat an thq 1st day of Ma , 20
1 (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tar Credit is hereby claimed:
❑ I (We) owned ❑ Are buying under contract AUG 3 0 2006
iHave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number I Page
' 0 6 03 E4s anc;sco =
Z- TRUETAX� —; ASSESSED VALUE +HOMESTEAD '� NON SIDENTIAL "
a" ASSESSOR USE ONLY I iYa
Aga �WVAI:UE "o. AT100 %TOFTTV ''?VALUE a es`VALUE
.z`r3. v ....,..�_ -.`.°. �aisv- f,._.... - ...it:..
Land not exceeding 1 (one) acre immediately
surrounding esidential improvements. 8-r +Y
9 P
Other land
(2) fire':4'
Total land (line 1 plus line 2) (3)
Dwelling (4)
'Residential Improvements or Annually
Amassed Moble / ManufaWUed Home Garage 6
Other improvements 6
Total improvements (line 4 through line 6) (T)
Total value (line 3 plus line 7) (S)
hereby certify the above is true, correct, and Signature of Assessor Date signed
complete.
Verifying action - Signature of Auditor Date signed
M&"=- STANDARD DEDUCTION ALLOWANCE. �'.ra�.ra�� •s.�„�,%:
20 Pay 20_ ,
Lesser of 112 Homestead
valuation or 535.000 $
W Date si
X30 -0
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?P.ROPERTY:�ESCRIPTION.?!r -, �. _ _. +,..u'9°�r; _t''6- .',1.0
County
I hereby certify the above statements are We, correct and complete. S
Township
Taxing district (city, to , t nship)
Parcel nunibqr
Legal 'ptio do x4s the property in question:
C;5S
-IL property ❑ Mobile HMO (M 6- f. 1-7)
If any portion of the residential structure or the land not exceetling one (1) rre mat immediatety surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
' 0 6 03 E4s anc;sco =
Z- TRUETAX� —; ASSESSED VALUE +HOMESTEAD '� NON SIDENTIAL "
a" ASSESSOR USE ONLY I iYa
Aga �WVAI:UE "o. AT100 %TOFTTV ''?VALUE a es`VALUE
.z`r3. v ....,..�_ -.`.°. �aisv- f,._.... - ...it:..
Land not exceeding 1 (one) acre immediately
surrounding esidential improvements. 8-r +Y
9 P
Other land
(2) fire':4'
Total land (line 1 plus line 2) (3)
Dwelling (4)
'Residential Improvements or Annually
Amassed Moble / ManufaWUed Home Garage 6
Other improvements 6
Total improvements (line 4 through line 6) (T)
Total value (line 3 plus line 7) (S)
hereby certify the above is true, correct, and Signature of Assessor Date signed
complete.
Verifying action - Signature of Auditor Date signed
M&"=- STANDARD DEDUCTION ALLOWANCE. �'.ra�.ra�� •s.�„�,%:
20 Pay 20_ ,
Lesser of 112 Homestead
valuation or 535.000 $
W Date si
X30 -0
- --I
County Township C
County Township
I hereby certify the above statements are We, correct and complete. S
Si7g�yfatu or daimon{ /
Add ss (number and street, city, state, ZIP code) J
Z- TRUETAX� —; ASSESSED VALUE +HOMESTEAD '� NON SIDENTIAL "
a" ASSESSOR USE ONLY I iYa
Aga �WVAI:UE "o. AT100 %TOFTTV ''?VALUE a es`VALUE
.z`r3. v ....,..�_ -.`.°. �aisv- f,._.... - ...it:..
Land not exceeding 1 (one) acre immediately
surrounding esidential improvements. 8-r +Y
9 P
Other land
(2) fire':4'
Total land (line 1 plus line 2) (3)
Dwelling (4)
'Residential Improvements or Annually
Amassed Moble / ManufaWUed Home Garage 6
Other improvements 6
Total improvements (line 4 through line 6) (T)
Total value (line 3 plus line 7) (S)
hereby certify the above is true, correct, and Signature of Assessor Date signed
complete.
Verifying action - Signature of Auditor Date signed
M&"=- STANDARD DEDUCTION ALLOWANCE. �'.ra�.ra�� •s.�„�,%:
20 Pay 20_ ,
Lesser of 112 Homestead
valuation or 535.000 $
W Date si
X30 -0
- --I
M&"=- STANDARD DEDUCTION ALLOWANCE. �'.ra�.ra�� •s.�„�,%:
20 Pay 20_ ,
Lesser of 112 Homestead
valuation or 535.000 $
W Date si
X30 -0
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