HomeMy WebLinkAboutHomestead_Fox (3)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
` ' State Fortn 5473 (RB / 7-07)
Prescribed by Ihe Departmerri of Local Cwvemment Finance
INSTRUCTIONS: See ravsrse side fo� filing ins6ucfions.
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FORM
Hcto
YEAR
I(We) �/�/�'✓� O� �� �`� cert��t on � 2�y ot March, 20
I(We) oxupied as our prindpai place of residen e e fdbwing described real property ta which a Homeste peAy ac Gedit is hereby daimed:
�n I(VJe) owned ❑ Are buying under contract ���J/°���.
iave a beneficial interest in Me entity that is liable fa the property tazes an the property and that rnms the ro or is b�ying upder a contrad.
_— __,..� �.,�iu7Y AUDITVR
If byvig on canVact, fee Simpa wmefa name
where conUad is recortlad
Township
Tadng disUicl (cily,
Recadnumber �Page
Paicel number Legal Cescnption Is Uia ploperry " quesGon:
��-ia-o�-ao3-oo,� S88-o�� [�Realproperry ❑ MobileHome(IC61.1-n
N arry portion of Ihe residerNal sWdure «Ihe Wnd nIX exceeding afre (1) acre Ihal immediatety wrtounds Ihat sVUC¢ire is used W produce mmme, tlescnDe 1he use and porfbn
of Uie prcqerty NiGZetl In Pmduce inmme.
Counry
Tarnship
I he2by certify ihe above statemenLS are We, correct and complete.
�ess(numberardsUeet�}tstafe,,andZJPcoda) .
Land not ex�rg 1(orre) aae immediatey
surtounding residential improvements.
Otherlark
Tdal land (line 1 pius Gne �
owenug
Resdential improvements or Mnually
Assessed Mobile/ ManuFacWred Hwne
Garage
Other irnprovements
TUaI improvements (line 4 fhrough line 6)
TUaI vatue (line 3 phs line �
I hereby certify the abwe is true, corred, and
camplete.
Veifying adion - SignaWre oi Autlitor
(�)
IZ)
(3)
(4)
(5)
(6)
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�8)
Si9naWre of Assessor
�� PeY Zo — 45.000 for 2007 pay 2008 42.000 for 2010 pay 2071
Lesser of 12 qq,ppp tor 2008 pay 2009 41,000 for 2071 pay 2012
Homestead Valuation S
« 43,000 for 2009 pay 2010 40,000 payable after 2072
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Date signed (mmN. tlay, yea�
Data signed (manlh. 4aY. Y��)
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