HomeMy WebLinkAboutHomestead_HolleyCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form Sd73 (Rfi / d-03)
Presaibed by t�e DepaRment of Local Govemment Finance
INSTRUC710N5: See revarse side foi (ling insbuctions.
FORM It\� YEAR _
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I (We) `�'` . . , � - .. ti.�. � °.�__ �/ «�!`� W�'-"�-�-., '�r,�?-��� certif that on the 1s da� rch, 20
I(We) occupied as our principal ptace o( residence the following described real property for which a Homestead Prope[ty T�c Credit is hereby daimed:
� I(We) owned ❑ Are buying under wntrecl �� ��
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Have a benefidal interest in ihe enGty that is liable (or ffie properry taxes on the pwperty and that owns the p����v(diiriyTnlj drld�fifl9ntracl.
I( buying om m�traG, Fee Simple owners name
Retorders olfica whera conttad is recorded
��¢"�t�;,`�`:"�?�Z°Y c��`"i+�cc?s'_�x'�
�nh Tamship
Strict (ciry, town, township)
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Rewrd number � Page
Parcel number al descri Gon "
� �] Is the property in question:
t S 9 a �Q `-3� �J y9 /� � _� ❑ Real propeM ❑ Mobile Homo (I.C. 61.7-7)
It y poAion of the resiEential sWqure or the land na eaceeding one (1) aae t�at immediatety surtounds that swCUre is used tn produce income, desfiibe Ne use antl portion
a ihe property utiGzeC b produce income.
?-lo-/d-�`�'�Dd-003.lot4�-O l� . ,.. , ..
��`.��':-��`=�=�"'.���„-�'1;�'`�.:rxia`51u�`3'�d:.<�`__�,'--`.�STANDARD`.DEDUCTIONALLOWANCE .-z>a.:h�it#.'`s��nS:.��xzW�;�_"-3�^r.J,.—'-��-F'h'ss�_`S�'`'"'���•�
20 _ Pay 20 _
Le;ser of 1/2 Homestead
vauauon w 535,000 S .
Synature oflwditw � Date signed