Homestead_DayonCLAIM FOR HOMESTEAD PROPERTY TAX �� FORM YEAR
- � CREDIT/STANDARD DEDUCTION H p �
` Slate Fortn 5473 (R8l 7-07)
� Rescnbed the
by Departmerrt af Laal Govemment Finence
lNS7RUCTlONS: See rBVerse side lor fili� insLucUOns. �,; qy 009
_ ,� .
� M�e) certii�'9(8 hYY� y of March. 20
I(We) ocwpied as our �prindpal place of residence the f lo 'ng described real properry for which a Harle�$�,����17(I�reby daimed:
I(We) owned ❑ Are buying under contrad
Have a benefidal interest in the entity thal is liable for ihe property taxes on the property and that owns fhe properry or is buying under a contraG.
If Wyuig on coniract, Fee Simple ownels fmme
Recordefa d6ca whera conlraa is
Tawnsfdp
Tm�ing
Is Iha
Recwdnumber �Page
��-I d-U' /-aud-uw. p� �� �dx � � ProPanY ❑ Mobile Home (IC 61. f•7)
If eny portion of Ure residerrtial swcture w ihe Wnd not ezceedirg orre (7 ) acre that immediatNy wrmunds Ihat ra is used m pmduce Imprtre. describe Ihe usa and portion
of Ihe property NiBzetl b pmduce incane.
�. � � • .� • �
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Land not exceedirg 1(orre) ave immediatey � ,F,� `4,�. 3��, :. �. ri: sF ::
surrounding residential improvements. � � ,��:�.��� .s . � -��`; � . ..
f.�
Other land (2� - -
Tdal land (line 1 plus line 2) �g)
:�k-0r � .. '�x .. _ .
ResidentialimprwementswMnually �m� �4) '" { -`Lr.,^',,`,� ,+.�:.�. ��;;�,�.
ASSeSSed MobBe / Manu(acri�red Home .: y w�-; � S. x-•.
��e �5) - .• `"••-',*1.}`.-'�` :.r"'.��_�_ _ ;-
�:+.�.�.'• . •.
Other improvements (6) - ';:'t'-. �`'
Tctal improvements (line 4 throuqh line 6) �7�
Total value (line 3 plts Gne n �g�
I hereby certify the above is W e, correct, and Signatura af Assessw Date signeC (month, day, yea�
complete.
Vaitying adian - Sipnature W Audtw Date signed (ma�N. day. yee�
� PeY 2� _ 4,5,ppp for 2007 pay 2008 42.000 for 2010 pay 2011
Lesser W 12 qq ppp {or 2008 pay 2009 41,000 for 2017
Homestead Vaivation �Y Z��Z S
« ^ 43.000 for 2009 pay 2010 40.000 payable after 2072