HomeMy WebLinkAboutHomestead_Hardiman (13)., AR•n 4s CLAIM FOR HOMESTEAD PROPERTY TAX
� '� CREDIT/STANDARD DEDUCTION
'� •• J State Form 5473 (RS / 70-01)
Presaibed by Ihe Department of Local Govemment Finance
INSTRUCTIONS: See reverse sKle /or �ling insfructions.
I: • �� li'�
i ;�'
JUN 0 4 2002
� M/e) ` V1 . ' ceNf✓u'rgt en'tln.+v��ka�kletd�8-�(
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I(We) o upied as our principal place of residence the toli ng descnbed real property (or which a Homestead Pr���cCCiiilif Isth�el�ebyTCnfa�mec
❑ I e) owned ❑ Are buying under contract
. Have a beneficial interest in the entity that is liable for ihe property taxes on the property and that ovms the property or is buying under a wnVact.
If buy'ug om m�traq, Fee Simple owners name
Recoidefs otfice where contracl is recor�ed
?-�v.�����Y--�c°'.i.�'�`�.-ib`F.3-n+.�'t-` 5'._i.�}�.'�€e
Couny"' � Tamship
I( any poAion of ihe residenUal sW cture w the
of the properry ut�ized b produce iMOme.
Rewrd number � Page
Tating Oisirict (ury, town, townshiP)
Is the o�aDeM �
5"01-1 U I /�� l, �r �lN�e� P�operty ❑ Mabile Hwna (I.C. 61.1-7) .
one (1) aae mat immetliatety surtounds Ihat swcture is used b produce income, describe ihe usa and portion
���� � AS E SOR� E ONY—�`��� �TRUETAX � ASSESSED VALUE 4.+HOMESTEAD '` s��'NON-RESIDENTWL��•'�
-��.i�k���i�;3s�at4a£{�:'�.�an$��`;'�,� ('d�,x+,VALUEa„��G �rAT>100°/a OFTN� ��,siVALUE�� �����.�7�t;;"VALUEj��, ,�'�
Land not exceeding 1(one) aae immediately r3'iy� ��';-�""'"'� {- �'r
sunounding residential improvements. (�) '�'3" r `" �� `�� f 4.
�,�? � :a;y�l'� �"��y�' .
Other land p j'�'.w*-= �"'-�""'�" ��
( ) ksd�t,:;:;t:�'=:�
Total land (line 7 plus line 2) �3)
`� � �,' � '� ` ��'�r� .,° v:
Dwelling (4) - �.�,'��v4i1 �:����"��.
Residen6al improvemenLS _
Gara e r. �"���.�- F y S'-�`�r� ��
9 �5� ^. h'i``"3'u�ss�.� ..�,_ .� ���
�g -"�'�v kat
Other improvements (6) � ��%.4�.°'��
a °1*"5
Tdal improvements (line 4 through line 6) (�)
Tdal value (line 3 plts line � (g�
I hereby certify the above is W e, corred, and Signamre otAsussor �ate signed
complete.
Vvrifying aclion - Signature oflwtlimr Dale sgned