HomeMy WebLinkAboutHomestead_Hofman.; rt�� � CLAIM FOR HOMESTEAD PROPERTY TAX
" � CREDIT/STANDARD DEDUCTION
` J State Fwm Sa73 (RS I 10-01)
���� Presrribed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side /or filing instructions.
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I(VJe) certify that on the tst day of March, 20
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I(We) occupied as principal place of residence the fol ring descnbed real property for which a H'om/estead Pro� �T� � Cre�t�i ieby daimed:
❑ I (VJe) owned ❑ Are buying undercontract �`' �� �'�1;':."'• �
�lave a benefidal interest in the enii ihat is liable for the m e taxes on the ro e C:Jc v� � v�✓'� "'^'r
ty p p rty p p rry and Ihat owns the property or is buying under a contract.
I( huying on tontrad, Fee Simpie ownets name
Remrdels offica where contrad is recorded
County
If any portion C
ol the property
Tavnslrip
� Legal de:
:idential sWcture or the Wnd not
to oroduce inwme.
Record number � Page
Tating district (tiry, fown, fownship)
Is Ihe property in question_
❑ Real propeM ❑ Mobile Homo (I.C. 61.7-))
(1) aae t� t imme iat�sunounds that swaure is used to produce income, descri6e the use antl ponion
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T`,�,•'"��-�����'�.,=,m,�-`�t���j� ,ht+:v-,�?�iFROPERTY:OWNED;BY�CLAIMANTIN-�:OTHER'COUNTIES�x.�:�:qi`f.��'t ti-�i�.'�',�`r.�, �rct�.,.�:.�tifi,c�.
County Toxnship County Tavnship
I hereby certiy the above statements are We, wrrect and wmplete. i9nature ciaimant -�
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ireu(n 6eraMSbeef, ' sfate,ZlPCOde) �
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v xT: . .+».��'�-c.y.. rv4'}'.riw .� � w ii V° C.r'" � v . _ _ , L . . . ._ e. :.
�'i�. � �i �. TRUETA7( �� + ASSESSED VALUE t HOMESTEAD � � J'sl°NON RESIDENTIAL`"` ^��:i
`.�x�„x:� ��-'AS�SESSORUSEONLY �.�{�3;�,� ��-VALUEy �{� ..� AT.100%OF'T7V .„.js; VALUEµf,�s+�'. �p�',���,,s,-YVALUE_�$ ��,�
s.Ea�} �s�%�.�� 3�:?;�Ti��_� �.�
Landnolexceedingl(one)acreimmediately �;�J 1,�,.�� ° }-1- '`"5�t�;?-
surroundingresidentialimprovemenLS. (�) . � '•�-'%F--i;;�;�{}S��_:-�;°;;"�j���
` ��� ti ; c ' '
Other land (z) i ���.BE�..-.,�,
- �_�.>_,,.
Tdal land (line i plus line 2) (3)
�°,s�, .xy��t'- �'„ �r`.i��3.�' {^�'{
Dwelling (4) rr6� � � � s �' �'`w t'.
Residential improvements ��' '''"� �"�°'�' '�"�d�` _�
a 4 :t ..i
Gara e r'��`�«�x ���. r.._'�.,�,�_:
9 �5) •�'•`� `e3.: ,,`�'.`t'� ..�'��
...�'�y �� ',. •
Otherimprovemenis (6) ���� k` ���'3;?,
Tatal improvements (line 4 through Irne 6) (7�
Tolal value (line 3 plus line n (8)
I hereby certify Ihe above is We, corred, and Signature of Asseuor Date signed
camplete.
Vrrilying aclron - SignaWre olAuditor Date signetl
�atLr.�,'T�.�_�:3`��.%�3��e� --'�rP''i?t�"�"�—.«STANDARD:DEDUCTIONALLOWANCE t�y�;:'�'�.�j:�`.U�,:�.,�-y�z:,-�a" .�"�...�: :'=.x'"�'r 'c.Zo-yl'i+Y'.�+>`` '
20 _ Pay 20 _
Lesser of 1f2 Homestead 5
ValuaGon or 56,000
Sgnature of Auditor ` Date si-ned J= O�
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