Homestead_Wilhite� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fwm 5473 (RB / 4a1)
Prescribed by the OepartmeM d local Gavemment Finance
INSTRUCTIONS: See reverse side for filing inslructions.
FORM
HC10
YEAR
� �e) �g cer t�a �Yi'b�n�i�e7sl �March. 20_
I(We) occupied as our principal place oi e idence the fo�laving de �bed real property fo ich a HomestgatY F1rop� 9 Tgn6rgdit is hereby daimed:
JCf � LUUJ
❑ I(We) owned ❑ Are buying under wntract /J
= Have a benefidal interest in the enGry ihat is liable far the properry taxes on the property and tha�qwns the propRrty b�Ns buyiqg�under a conVact.
If buy'vig om m�traq. Fee Simple owner's name
Recorders oi6ce where conVact is recorded
RemM numDer � Page
��Y 7ownsAip Tacing Oislrict (riry, town, tawnsl4'b]S%L�^ ,� �/ �
v c�uu/< <t
Pa I n r �' I Legal deuription ihe r
puestion:
� � — O Real property ❑ Moblle Homo (I.C. 61.7-n .
H any poAion of the resiEenUal aWChire w Ne land not exceeding one (1) aae Net immediately wrtounds tha� sWCNre is used lo produce income. describe the use antl pwtion
of the property uWized to produce irrcome.
County
I hereby certify the above statemants are We, corted and complete.
AdC�e3a{nymbar and streef, cify, afate, ZIP code)
of
"�'" r'��' '-`:'-'`�"--�'4-n's'ry��''.�'�;�'s#� 3i" �UE�TAX� -ASSESSE�6,Yf UE� �HOIdESTEA� � . . �^ - ..
`�ASSESSORUSEONLY'x �L;�x a.� . � ,,, :y � �s��_N�O�,N�iESNENTIALm�
- ..ua,t'-�xR-'r'?3t�' .k'E'i�.-.°,R�..�i.?.-+�'�s{.... �Yi ��...'VACUEl.c�� ''-.tip..T.{10M.6,'OF1N,: u.."Y :VALUE c rt„ i.s �f':�.k.ALUE�.,.�.��.�..:%r�
Land not exceeding 1(one) aue immediatety Gh1 y�"�'r .�,...�"'�, y,� �t��-.�•° .;,<
surroundin residentialim rovements. (�) -T't�"3't�`''� �K�
9 P u rt:�3��.<�_K�''�.
Other land .]��'''��� �
(Z) "��"itj= `'�`T`Y .
ti...y.,Y�r.i%'E\/:�t:e�
T�tal land (line 7 plus line 2) (3)
Dwelling (4) �:<�i^yz�',"-?'��^';f�;{`�'�=�f�jfs.��::�
Residentiel Improvements or MnuaOy
+.'i.�:�til�bi:(u<c?S`:�':i? �'t'a`.iwc:�'ti
Aeaessed MohHe / AlanufacWred Hana Garege (5� `� ^,�i.�,ry.���;��.e;sy�� x�
�: � 3wi Y r � i : : �' � : � �C- 1 .�� ` ., . ; %i e
m - `;
'i"P.�F,� L -�i
Otherimprovements (6) ' -��i� =• %r�'?';
:�.L:i. w :�;�:
Tdal improvements (line 4 through line 6) (7)
To[al value (line 3 plus line n (g)
I hereby certify the above is We, corred, and Signature NAssessor Data signetl
complete.
Verifying action - Signature o(lwditor Date signed
�.� ��-- �' �r.; .�� i� Tt � .._� r�. i . .;r �• . ,� � x�,„.ati,�.. .. ;,,.y�d �g. . . .
� .�'.. s�'�'.-..a'�+-zfi .�..:.zetn"'�. {i..s�5$'''< , ..si.�+STANDARD;'DE�UCTION'ALLO.WANCE -� r:+'e. ,. tiJ,�.....nz..--. _.�rr�' . -i�. _.:'-
20 _ Pay 20 _
Lesser of 1/2 Homestead $
Velua9on a 535.000
SignaWwollwditor - Dalesignetl