Homestead_Young (10)��;,� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� � Swte Form Sa 73 (R6 / 403;
Prescnbed by Ne DeOartmenl of Local Govemmen� Finan¢�
INSTRUCTIONS: See revcrsc side !or /iling insbur,hons.
FORM \V\ YEAR
HC10 �
��e) ce a on e 1sl day of March, 20_
I(We) occupied as our principal place residen lh following desuibed real property for which a HomesieaQ �rpp@�ty,7aq6r�it is hereby daimed:
M t< <, a cuu�
❑ I(VJe) owned ❑!ve buying under wntract
; Have a benefidal interest in the entity Ihat is liable for the pmperry taxes on ihe property and Ihat owns the,p{pperty orasjwying untler a contract.
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If huying om m�iract, Fee Simple owners name
RemMefs olfice where contract is recorUeO
Tavnship
U(��poa�3-�
If any portian ol Ue residenual sWCture w
of ihe propeny utili2ed ro protluce intome.
Recortl number
.. .: ..i� � . .-� �
Page
Tadng EisUict (ciry, town, o hip
�� � � r Is the prope�question:
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V eal property ❑ h7abile Homo Q.Q 67.1-7)
eaceMing one (1) acre �hat immediatey surtounds thai sWCture is used m praduca inmme. descri6a ihe use antl portion
f� J�� �'' ASSESSOR�USE ONLY . ' . TRUETAX ASSESSED VALUE .'HOMESTEAD NON-RESIDENTIAL;
.., .
_.,?+.ir� � ., • . . �'�.. s:, r � . �: : ' ' �. . •� VALUE AT 700 /a OF.TTV - : � VALUE .. � ,:-? . VALUE}� : :" ��.
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Land not exceeding 1(one) acre immediatety _ (�) I -, - -_ _
surrounding resi0ential improvements. I . : • ` -.. : �
Otherland (Z)
Tccal land (line 7 plus lins 2) (3)
- . -ra� �_ '•. • ..;.
Dwelling (4) '�:;,._i:':�<�i�;:.�z4i..M_:;;?;:�'-
Residen6al impmvemenLS or Mnualty �•' ``.`• r .
�.�--�o,;:-:;�=�:�-r>= _-
AssessedMobile/ManufacluredHome Garege (5) - .dx•°.,''�^'.: ;:i7 `.
Other improvements (6)
Tcial impmvements (line 4 tbrough line 6) (7�
Tdal vaiue (line 3ph.s line n (g�
I hereby Gertify �he above is We, correct, and Signawre of Asseswr Date signetl
wmplete.
Venlying actbn - SignaWre oflw0imr Date signed
20 Pay 20 _
Lesser o� 1/2 Homes7ead
v�uauon or 835.000
-aSTlWDAR�.DEDUCTIONALLOWANCE -
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Date si 4
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