HomeMy WebLinkAboutHomestead_Craigrt, CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Sla�e Form 5473 �R6 /4-03)
Presaibea by the Departmenl of �ocal Govemmenl Finance
INSTRUCTIONS: See revcr�5p..r��Aslor /iling insliucfions.
�a� FORM YEAR
HC10 �
I(VJe) � L ' ceitifylhaf on the 1st day o( March, 20_
I(We) upied as our principal place of residence the owing described real pmperty for which a estqa LPrrop �rty�T�c�f�redit is hereby daimed:
I(We) owned ❑ Are buying under contract � � -
' Have a benefidal interesl in the en6ty that is liable for the property taxes on the pmperty and iha[ owns the property oi is buying und�er a contract.
If bying on conVact, Fee Simple ownefs name
Recoiders ofice where conVad is remrCed
Record number � Page
County Toxnship Tating tlistricl (dry, town, townShiP)
Parcel number Legal tles "ptl Is the pmpe in stion:
�' ' 9 Real Droperty ❑ Mobile Homo (/.C. 6/.1-�
If any portirn of Ihe residential sWCWre w the land not e ing ona (1) aQe ha � mediatey wrrounds thal svucture is used to produce inmme, describe the use and portian
of Ihe properry utiized m produce incoma.
aDS �o��
�u•�:�A�A��s5i��4` ``���'� �*° �L"'F�: t TRUETAX i'� �ASSESSED�VALUE 3aHOMESTEADF a"�'+ eNON=RESIDENTIAL t �?
�.SASSESSOR;USE ONLY'e'�e��,y� �-�tx� �'�'�VALUES�isi+�.'}'�. `AT 100°/a OF'TTV ; w'[�` VALUE ��f" �� '-� .,� '+` '��'�
i���.,�A�i.v3Y�A iWn�� N_daq_JC:e�T.�u� � dri >-r an[a.a .� xi+Yg'�a �..N. V�VE't
�� T�
Land not exceeding 1(one) acre immediately J� .: `„� i'.�rs$
surtounding residenlial improvements. (� � �� ��� F"�t°�� }'`�;
,.,�.�.4,. <:��s� `�_'.,'��_�.
Other land (Z) ��,c��r �r���`.��'9. � �
�� �.8?'��:ia:;
Total land (line 1 plus line 2) (g�
,�-'�"�s�,�,�� ��4���-�+°' :;:.
Dwelling (4) ��_e„r��!_,���� ss�s,�
Residential improvemenLS w Mnuairy
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Assessed Modle / ManufaQUred Hmie Garage 5 �z r �` �'��' ��
� � �ti�� .+�k5��'g����:
F.`s�a. �'�'i�tn^2'. P i
..:y,.al�' -.,'�•{'S
Other improvements (6) h�`_".-� �� r��'� � ,.
' z'f �;;9 �'e��
Tdal improvements (line 4 through line 6) ��)
TRaI value (line 3 plus line � (g�
I hereby certify the above is We, corted, and Signature o(Assessor Date signed
complete.
Verifying acGOn - Signature o(lwditor Date signed
��,i�f��� _�e'.-�"•`�a37�.`�*�i-'�3�5iw���i=STANDARD:DEDUCTION�ALLOWANCE .'-`�."r�'�i`fi,°vr�'a.�Y-y`F�2�-�'n�"'r"�"-�r<�ti'3��':%s ��
20 _ Pay 20 _
Lesser of 1/2 Homestead $
VauaUOn w E35.000
SgnaWm aflwdilw " Date s'gned
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TAFA.�VPIIIFIXtMTSIR
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Individuals and married couples are limited to one homestead standard deduction. As the receipi of this
deduciion becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead
�fraud causes higher tax bills for all; therefore, HEA 134J-2009 requires taxpa}'ers who receive the
homestead standard deduction to ��erify that they are eligible to receive the benefit and to provide
additional indentifying information necessar}�'to allow county go��ernment to better monitor homestead
filings. This information �cill be kept confidential and can only be accessed by authorized county� officials.
The Department of Local Government Finance ��•ill use this information to create tools that will help
county officials eliminate homestead fraud.
Addrtss (numbcr and sveet, city, stare, and ZIP code)
�QOS 1,� /.3�
Parcel �umber
� //—��' /Q �.1 '
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; Addrcss (number and street, ciry, state, and "LIP cade)
Number (las�
� QJ I
umber and sveet, ciry, state, and ZIP caie)
,
� % �
ID Number (IaSI i
, ' /
i dfgits) Drivers LiccnselSmte ID \umber Qast i di�its)
�,,,.
Same at
(pleaze specf(y m Part 4 below)
Middle .
Same 3s o rty addres5
(please specify in Pan 4 below)
�Q��
undersiened certifies, under penalty of perjury, that the above and foregoing information is we and cortect and that he or she is
le to receive the homestead standard deduction on this property. Each undersigned also understands that, by claiming additional
stead deductions unlawfully, he or she may be liable for back taxes and substantial financial penalties.
I Sienature Date Telcphone
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