HomeMy WebLinkAboutHomestead_Boyken' CLAIM FOR.HOMESTEAD PROPERTY TAX
° CREDIT/STANDARD DEDUCTION
t / Stata Form 5473 (R6 / 4-03)
w
' Presaibed by the Dapartmeni of Local Govemment Fnance
� INSTRUCTIONS: See /evarse side /or filing instn�ctions.
FORM
HC10
YEAR
��e� —"`�`^""� � \�'v W`�' �-' certify that on the tst day of,March, 20_
I(We) occupied es our prindpai place of residen the fdlowing descAbed real property for which e Homesteed�Prope[ty.T�c Credit is hereby daimed:
�I (We) owned ❑ Are buying under co�Vaa - .-.�.. .
Have a benefiaat interest in Ne entiry Nat is liable for Ne property teues on Ne property and Nat owns Ne property or is buying under a conVaa.
i., .
I1 buying on contrap, Fee Simple ovmels name
Recordefs office where wniract Ia recwded
Racord number � PaBe
. . _ _'_"_"__.__.___`._-_. ...._..,._., ...--.'_......_"'....,.._..... ... � � p'-.-. ..:� .,... ::........ . ....:_.. �
Counry Tormship Taci 'q (crty, town, townshi
P rcel number Legal description Is Iha property in Ouastion:
� l q-a i 1�U8 -� I� eal pmPerty ❑ Mobile Home (I.C. 67.1-7)
It any portion ot Ne residential sWdure « the IarM not exceeding ona (t ) acre Nat immadiatey wrtounds that sWaura is usad lo produce incoma, dascribe Na use and portion
of the praperty uul�ed W produca income.
a�-ii-l�-yva-
-G �
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��� �'�.�.�'6+''*kmK=r.'�i�:a3i�'�'n£`•='t?��PROP,ERT1!.OWNED`'.BYCL'AIMANT;�N;OTHER��COUNTIES:�.v v:-':s= <,�-,t,`..�. -?:.:L"`-,,.� -
Counry 7wvnship CouMy Tavnshlp
I hereby certify the above stelemenLS are Wa, cortect and complete. Signawre oi Geimant
rass (number end sUeet, tiry, atate, ZIP code)
�-`�"+"-����ASS SSOR US ON Y�' �`�> u�Y��� �TRUE TAXZ.�hr ASSESSEDYALUE ��HOMESTEAD ��.�� �NON RESIDENTIALK:¢=-`
4�� [. __ `Fai%e.t:�:�'.�`»tY+..�.r.i;,.�_�a z�r.,t� �VALUE�.�f,"�`� °_ATj100%OFTTV ✓-?'.VALUE ��'x `��''-�'•v`';_VAl'UEs� � ��?'
t' __�-;,::__�,.ra:#� �.,••.
Land not exceeding 1(one) acre�immediatety ��� F�:;r 'r �� y �. �."h
surrounding residential improvements.
��� s �r-. �i;°ti " :v,�:�,)> -�.i:
Other land � �J �
(2) � H _'
� , :i:
Tctal land (I/ne 1 plus line 2) �g�
Dwelling (4) ; R ��� �r,r � `��-� � �, � .�'
Residential improvements or Mnualty _� +� -� s �,;'� � -�.;.; ,r ; pt
Assessed Mobile I Manutactured Home ;�,M1 � �,�...n � � - ,:� � �
Garege �5� �,,,,�.3 �.:�' .;� � ,
'"'�"'�w.� f�l:`.;.Y..�.�1 '
y,� _..-..L::` :'2P ":: �.
.O�per improvements (6) '� _ <..:��-�.��.? � '
i , � y_v�r� .
Tdal improvements (line 4 through line 6) �7�
Tdal value (lina 3 plrs line n (g�
I her9by CerUfy the above is W0, CorreCt, end � SignaWre of Assessor Data signed
complete.
Vaifying acUon - Signatura oflwditw Date signed
���`.1'�M.d:'�^'.:k;'�x x:�����:��7�.t.}'`:.�.:n'�, •�.�STlWDARD',�EDUCTION'ALLOWANCE . �'s-:.;";
20_Pay20_
Lesser of 1!2 Homestead
Valuation or 535,000 S
Signahira of Puditur Oa:a signed