HomeMy WebLinkAboutHomestead_Hiatt:. r ;\ CLAIM FOR HOMESTEAD PROPERTY.`iAX
! CREDIT/STANDARD DEDUCTION '
\� / SI:neFurm>.79(R61403) .
PiescnbeJ by ��e Depanment ol Local Govemment Fina�e: -
INSTRUC ilUNS: See revasr, sidc Inr liliny msbui;fio�is �
• n FORM YEAR
' \ � HC10
fATEMENTr__:..•_.-=^�•.���.-; �..APR 2���':�9fif1G� - . � I
I(VJe) _ _ ��_�/` � ceAify Ihat° �tjh� 1st d�a �arch, 20_
I(We) occupied as our principai place of residence the foliowing described real property for which a Homesiead Propeity T�reLfl reby daimed:
❑ I (We) owned ❑ Are buying under confract ' ^ � ' " � - �""' �i IpITOR
` Have a benefidal interest in the en6ty Na� is liable for the pmperty taxes on the property and Ihat owns the pmperty or is buying under a contract.
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.-� a}".*w?s+� ` •�- a.':�s. Yx' i.>'s= i��- `' -„_S =':CONTRACTRECORDED-."�s; z �.�, - � �r , -
If buying on conirad. Fee Simple ow�rs name � •
Remrdefs otfice whrle contracl is remrdetl Record number Page
County
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Tamship
ESCRIPTIDN--�s'` �;'} -. - z '"�. -
Tsing tl¢trict (dry, fown. township)
3v l_I I�� 9 e li . /O I Is the Pmperry in question
a ❑ Real property ❑ Mobile Nomo (/.C. 67.1-7)
+dential stn�Guro w the lantl nol exceedi`g one (1) aae Ihat im Oiatety wrrounds lhat swcture is usetl to produce income, describe the use and portlon
to produce i�xnme. I' � L ���
?..;-x-�> a ryr+K:'•,' .,, _. ,:-�?; �� _ �:.; ,'�;�� P,ROPERTY.OWNEU�'BY CL'iIIMANT;I �.OTHER`COUN'iIES ?i .''�"+�. � �i3 35.4����i.a".! � ' -� ' -' "'
County . Twvnship ' Coun Twvnship
I h eby ceNfy the above statements are true, correcl and complete. 9 wre ot claimant
ressp1 num6er nnd streel, ciry, slare, ZIP code
tl-o�40.� ��Q
?��v.ke. �"F � � `' ""�'��"'Y i' v �-�Ti-''� f'�' �: i �TRUE>TAX . ASSESSED VALUE 4}HOMESTEAD': r ``�' NONrRESIDENTIAL"� � � � �
� b�.,,::{#;TASSESSOR�USEeONLY�y`��{h�t��Y��VAI:UE ..:AT100%'OF�T7V �.vVALUE$�r`����'�`3s �"'i;,:FVALUE�'„�,C�h��°'
Land not exceeding 7(one) acre immediately ' ' �,k �F,;�,.,� ti���. �'�-.;;
surcounding residentlal improvements . � � ..: s;�;_i�_ ;;;? ;., d,'.,:� F.:
Otherland (p) � ,�s,�'���;'"f ��"°''�� �
'� �.�5f_-.s..
Total land (line 7 plus line 2) (3)
i� +i, ' i �-'
Dwelling (4) .� i��,i.�. c � • �27'�1 = "�'.
Residenlial improvemenis orAnnually ��•�` � �`��r �Y �"�' f ��s
Assessed Mobile / ManuFattured Home Ga29e (5) .�ti�'r �i".'t:'''s��s.�� '�, 4: -�n:'.
i= § ? �
-`.o.Zi: s `_�?v-�d�',. ,(�3 r
Other imprwements (6) � _ ��� ;f
7cial improvemenis (line 4 through line 6) (7�
Tdal value (line 3 phs line n �g�
I hereby cerUfy the above is We, correG, and Signature ofAssessor Date signed
complete.
Veritying action - Signawre otAutlimr Date signeE
20_Pay20_
Lesser of 1/2 Homestead
va�uauon or E35.000
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