HomeMy WebLinkAboutHomestead_HerrenbruckCLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
� State Fwm 5473 (R6 / 6-03)
Presaibed by Ne Departrnent W Local Govemment Finance
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� FO YEAR _
APR 2 6 �'007
INSTRUCTIONS: See ieverse side for filirg instructions.
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_ � _.:,:�": �`� . . :yCERTIF.ICA710N-STAiEMENT � _ � �;; �''- " . �,s•'u3,;���5-,'" ?.
OIBSON COUN7Y AUDITO�i
��e) certify that on the 1st day o March, 20_
I(We) occupied as our princip lace of residence the following described real property for which a Homestead Property Tac Credit is hereby daimed:
� I(We) owned ❑ Are buying under wniract
Have a benefidal interest in the enfity that is liable for the property taxes on the property and that owns the property or is buying under a wntract.
I( buyiru� om m�trad. Fee Simple ownefs narne
CounTy
Parcel numbet
tl any poNon ol
of ihe properry i
where wntract is rewrded
Tsvnship
utlen�lal sWCture w the Wntl not exceeding one
N protluce incomea�
Record number � Page
tawn, townshiP)
the pro in question:
eal property ❑ Moyile Homo
that im�ty sunounds Ihat swcture is used b praduce income, describe the usa antl portion
��'���.'� A ES OgR USE ON Y����' ,ay i PL .. r{L .� �. TM � i a.
„�'c�� �.j s-s�te � q TRUETAX T' ASSESSEDVALUE +HOMESTEAD^ NON;REStDENTIAL�� }�
�,�,s,�t$3z,�i,;�,�>-,Y{.a �u.gy_�y� y?'����.�y�� £�.oVALUE�.�,u _AT1100%.OFTTV yVALUEf "� . y�.� VACUE f tik� €
>..,5... � �v,.-....,.,m�i`.`� ��. z.�...�......R'.w...�.��c.
Land not exceeding 1(one) acre immedialefy (') ���'�s'�- '+�sy. ���.��7s,:
surrounding residential improvemenis. ������z i. ,_ . ---,
Other land (z� `�`��r�C����
� n"s,..�:-f ���
Total land (line 1 plus line 2) �3�
Fti
Dwelling (4) � �� � �� .� ��9��
�ResidentialimprovemenfsorMnuaiy ' " �°' �'
0.ssessed Mobile I Manufactured Home Garage (5� : �e '�' `�
�•'e h�.�� °� .` � � ,f . .n��SX�Y��
:a:�:r��.•; v-y
Other improvements (g) �: .";i":��R:�
� 3�lf�ct 4�d_�S
TUaI improvements (line 4 through Irne 6) ���
T[1al value (line 3 plus line � (g�
I hereby certify ihe above is We, corred, and Signawre otAsseuor Date signed
completa.
Verifying ac�io� - Sig�ture of Auditar Date signed