HomeMy WebLinkAboutHomestead_Coleman (4)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
Stete Fotm St73 (R6 / 4-03)
PreaciDed hY tlro Departrimrh oT Local Govmnmmrt Flnarxe
� INS7RUCTIONS: See rewm dda b Rbp iet6uctior�
FORM V� YEAR
HC10
�� � � � �
I(We) 11.:/ V� `��� �(•� �{y �at on the 1 st day o( March, 20_
I(We) occupied s our principal place o sidence ihe (ollowing describe eal property for which a Homestead`�Pr.operty_T�c Credit is hereby daimed:
❑ I e owned ❑ Neb v�F(/ ��
(W ) uyingundercontract GIBSGN COUNTY AUDITOR
� Have a benefidal interest in the entity ihat is liable for the property taxes on Ihe pmperty and tliat owns the property or is buying under a conVaU.
I( buying on conVad, Fee Simple owmefs name
Remrders olfice where contraq is
Tavnship
[ ) IW-0l3 3 S -cx� I �t'
1 any ponion of Ihe resitlential sWqure or Me land not
of Ne property util¢e0 b produce i�ome.
County
Tavnship
Record number
Taing dislrict (ciry, fown,
Page
L^ ! 7_�r' J� I Is the Propecty i`yeue oon:
S V a�&eai roperty ❑ Mobile Homo (I.C. bf.1-�
�
one (1 � aae Ihat immediatety wrrounds that swcture is used b p�aduce inoome, desaibe the use and portbn
1 hereby certi(y ihe above statements are W e, corred and complele.
dry, sfate. Z/P �
hrb Jn
�
Counry
gn o c i I
, ✓� c 2�'u n ,�'
� (o `� O
�-�^ '�"'��'��'E"`�'''�`��xx��'+�'��"� TRUETAX`��' *- ASSESSED�VALUE HO(dESTEAD�'t ' '�' �� � '� �
ASSESSOR�USE ONLY ��° � $ s.. �NON�I3ESIOENTIAL4 u;�
�,� � .�,.�?u�F,o��..,����; �`�-'��„� ��s-VALUE�� "AT 100%'O �TT�V� � VALUE�,� �'�3ix,'�,i�VqLUE�;gL.��.
Land not exceeding 1(one) acre immediatety °""� ��`�'.,.}�. � <t=�i��?.j
suvounding residential improvements. ��� �' ��� � ��° ����(�-'
v� r'i 4L�i1� ?,��'�4 �5,��.
Otherland ", "Y«'��'��; -
�2� �<�:��
Tcial land (line 1 plus line 2) (3�
I��� } � 3r� 9
VWP.���n0 �4� � �4a b 4 �.A-� -�:..�C.�3�F^ �
'Residential Improvemenis or MnuaOy �'���-,� �' �-'��,�
„�,1��:
A�seased MobOe I Manufac4ued Hame Garage �5� �""�F���—��������
ti,
Other improvements (6) ��—��-'` s
�.`,����. -�x
Rlal improvements (line 4 through line 6) (��
I value (line 3 phs line � (g)
I hereby ceAify the above is W e, mned, and Signamre ofAssessor oate signed
complela.
Vuityiig actbn - SignaMe oflwdiWr Date signed