HomeMy WebLinkAboutHomestead_Martin (2)_a � ; CLAIM FOR HOMESTEAD PROP-ERT.Y- :TAX,; ; • �� FORM YEAR
CREDIT /STANDARD DEDUCTION HCtO
1 y Sl:ne Form y the (Renartm )
Prescribe;, by the Department of Local Covemrnenl Finance S
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INSTRUCTIONS: See reverse side for filing inuur.(idn :i' ' • - -
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- ,.- - CERTIFICATION STATEMENT:'
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I (We) certify that on the 1 st day of March, 20
I (We) occupied as our principal place of resi ence the following described real property for which a Homestead Property Thxd�sYaimed:
❑ I (We) owned ❑ Are buying under contract GIBSOOON''((COUNTY AUDITOF
' Have 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.
. :CONTRACT.-RECORDEDz',;:.;
If buying on contract, Fee Simple owners name '
Rewmers office where contract is recorded Record number. Page
County T:wnship Taxing district (city, town, township)
P I nu —� Lee es ' tionn Is the property in question:
lS�(J (��s/ '' O ° ❑ Real property ❑ Mobile Homo (LC. 61.1 -7)
r. My portion of the residential structure or the land not exceeding one (1) acre that immediately 071256nds that structure is used to produce incorne, describe the use and potion
of the property utilized to produce income.
a s, :f_� ._-•: fr., ,.�- _.H._�„�PROP,ERTY- OWNED�BY CLAIMANTINOTHER "COUNTIES ,�._�.. <�.... fry: - "
County
Township
Co ly Township
I he by certify the above statements are true, correct and complete.
ignature l ant
dress ( (n�numpbber and s L city, slate, ZIP code)
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•,y ASSESSOR USE ONLYu 5 rr.'.FS
:� TRUETAX4r -?
ASSESSEDVALUE
°
f,HOMESTEAD- -e3p
y
T�VON
Asp _. Ji
AT 100 /a OFT7V ..c
VALUE --:h:�
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-' VALUENTIA �Ss
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Land not exceeding 1 (one) acre immediately
-
surrounding residential improvements.
j ;
Other land'
(2)
x
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
_ _ 1eiir tit �
_' Rim '�Y jx'E
Residential improvements or Annually
_^
Assessed Mobile l Manufactured Home
Gara e
r ..- mss.. %z'"•e.°3'_. :1= i',y..- -7{rf..'':
Other improvements
(6)
; {`R
Total improvements (line 4 through line 6)
(T)
Tidal value (line 3 plus line n
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
of Auditor
20 _ Pay 20
Lesser of 112 Homestead
Valuation or $35.000