Homestead_Walden (7)" CLAIM FOR HOMESTEAD PROPERTY TAX
- CREDIT/STANDARD DEDUCTION
` State Fortn Sd73 (R8 / 7-07)
I
Prescnbed by 1he Depariment of Lonl Govemment Finance
INSTRUCTIONS: See reosrse side foi filirg instruc6ons.
� FORM
A HC10
1
�(we) �,l! N. 1" � 1 C.iI.X_.lLl'lV�- cercry
I(We) xwpied as our prinapa� place of residence the following descAbed real property for which a Homestead
YEAR
1(VJe) owned ❑ Ate buying under contraU FEB 1 8 Z009
'Have a benefidai interest in ihe entity that is liable for the propeAy faues on Uie property and Uiat owns the property or is buying under a contract.
If buy'oig on canVact, Fee Simqe amets name
Recorderc al6ce whme contraq is recortled
Township
Taring dislricl
Parc number Legal description Is �he proparty in queslion:
Recad number � Page
Oh0 -1 I ` d ( -T k/ �--lJi :��0 '�a / I /fi�� P�PaKY ❑ Mobile Fbme (IC &7.1-7)
H airy ponion of ihe residerNal sWUUra or Ihe Wnd nIX rxceedirg arre (1) acre Ihat vnmediatery sunounds Uat re is used W Produce income, describe Ure use arW ponion
of Ne prOperty u6Bzed tn pmduce inmme.
�_ � � � .� • �
��.•
Land not exceeding 1 (orre) ave immediatety _ _ ; �.. �: ' � � -
surtoundingresidentialimprovements. ��� _ � � �
Qther WrM (z� � - .
Tdal IarM (line 1 plus line 2) (3�
ResidentialimprovementsorMnually �elling (4) , .. • ,c_ '
Assessed Mobile / Manufactured Home . � . . . .
Garage �5� . . . . �
Oiher improvements (f) . :`'s�,` �.
Tdal improvements (I'me 4 through Grre 6) ���
Total vafue (line 3 pl'slirre n �g)
I hereby [ertify the above i5 W e, correct, and SignaW ie of Assessor . Date signed (rnmN, tlay, yea�
complete.
vaifying aeian - sipnawre of Auaitw Date signad (month. daY. reer)
tv_pay20_
Lesser of 12
Homestead Valuation
« ,. n
45,000 tor 2007 pay 2008 42,000 for 207 0 pay 2011
44,000 for 2008 pay 2009 41.000 for 2017 pay 2012 $
43,000 for 2009 pay 2070 40,000 payable after 2012
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