HomeMy WebLinkAboutHomestead_Brown (22)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
` ' State Form 5473 (R8/7-07)
Prescnbed by Ne Departmer� of Loral Gavemmen� Finance
INSTRUCTIONS: See raverse side /or filing instrucfions.
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FORM
HC10
YEAR
� M'e)� �+ �'� �-1 V�QW � certiry that �lh� 1� da� bf'Nf�rch, 20_
I(We) ocwpied as our prindpal place of residence the following described real property fw which a Homestead Prope`rt-yy Tym�c Gedit is hereby daimed:
�' I(We) owned ❑ Are buying under contrad p'�O+Z ��
-lave a benefidal interest in the entiry that is liable fw Uie property taxes on the property and that owns ihe ��pr����Tg'uAdl��QRi trad.
If Grymg on tmVad, Fee Simple ownefs tmme
Recortlafs of6ce wlare cart2G is recorded
Cwnry TwmsAip
Ii arry porUon o( �he residemial sV
or Uie propeiry �n;5ma m pmduce
Recwtl number I Page
Tmring disUiq (cify, Io•.m.
Is lhe property in quesUOn:
❑ Real property ❑ Mobile Home (IC 6-1.
the land nIX ecceedirg orre (1) acre that im�alety wrtounds ihat sUUCture is used to pmduce income, dewibe the use and portbn
'�• � � : � •
County Toxnship County To.vnship
I hereby certify the abwe Sfatements are tNe, wrtect and complete. Signah,re f dai
s c�umea, ane c an: sfa v zrP moe) . �/.y�
7 �
�_ � . � .� • �
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Land not exceedirg 1 (one) aae immediatey - - � - . . �". :.' -- � ' . . -
wrtounding residential improvements. (�� - - '. ' � -
Ofher land (Z� _ - �:. � �
_ .. `.: ,:> �
Tdal IarM (line 1 plus line 2) (3�
�t .
Dwelfirg (4) . ' _ _ _
Residential improvemenLS or Mnually ' - - .
Assessed Mobile / ManuFacWred Home �+ ' � �
Garage �5� " - - .
Oiher improvements (5) ..
Tdal improvements (line 4 through lirre 6) �7� I
TUaI value (line 3 plus Grre n �g�
I hereby certify ihe above is We, cortect, and SgnaWre ofnssessor Date signed (monm. ea� yea�
complete.
Vaifyirg adion - Signature oflwditnr Daie signed (mmN, daY•Y��)
�..� � � • �
`� �Y Z� — 45,000 for 2007 pay 2008 42,000 for 2010 pay 2071
Lesser of 12 qq ppp for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead ValuaCOn $
w 43,000 for 2009 pay 2010 40,000 payable after 2012 . _
SignaWre oF�inr Date signed (manth. day. Yee�
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