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HomeMy WebLinkAboutHomestead_KayCLA[AA FOR HOMESTEAD PROPERTY TAX CREDR/STANDARD DEDUCTION smm rw� sar3 (R� i 505� P�e�bed by Ihe DapertrreM d Laal Gora'mad Fra�m INSTRUCTIONS: See ieverse side /or filing insbuctions. ��� FORM � HC10 I(We) � '"" cerfitY Mat on the 1 st day of Ma�, 20_ i�we� ocA,�a 85 «Q �am w� �r ��d� roa��y a�a �i �y rQ Wnw� e H��a a�l� fL� 4.�iGr,��r ��a: ❑ � M�e) owrww ❑ ae ouymy urwa ooncact yr, � Have a benefidal mfafesi m tlie entity Uiat's liade Wr tlie poperty �ces m Me propaty ard Mat owns the PR��"7 "Y'P � a contract wc,. , �. : - - .'3-'-:�.. . ...��. :'. ,.. -si� ti�..':t:$. n' y�.. �.r.�,.'?���ib,'�: . i't':'COP17RAi'.TeRECORDmb':�..du..��,:t.°'t�fl�..;� �, e.�.:. �<sriisa,��;c4tTt��x'a��y�'�:7.3rrmt�.^RF.�.'. tl biryM9 am m�trecl Fee Sirtqle o�vnera rerre �� �e W�ae mYrad u recaded Remrtl number Pega �b ail . 't,ra Town4ip �''��'.` ..����o`,�u-'::y.``y'�" (riY. trswn. townxlep) _. Percel rw�er � L descriptlan , _ J/�(/L— � Is tl�e pupmq n quesbon. �� � ❑ r�m aw�y ❑ �b � ��.c. s,.,.n rc poNOn or u,e r�ide� ewmre a. n» ta,n na ona (1 � ave mat Rmed�dy ama,� nm mumre ia used m pmd�ce nmme. easvbe ma �me �d parCOn d P�Pa�Y �imd b pioi4�ce e�mrne. �-!d -18- 3o�-Da3, a3 K-o �-8 . , . �r.�>. __ _ _ , . ,.� �,.� , �;� .-:,.:t,`�..' -� �� ,�. ... _�,.:.A: � i�" c .. •..17,PROPEHTY�OWNm�Br�CI'AWANr.a'oTHBt'COUNRES f.,'. ... a.�;1[�:SKSY,.�',,:�?nrv�A�:. t.r�.tr.�.,4�. County TaYnship Counly Tawnship I tiereby certiry 8ie above sta6ert�ents aie true. correU arid corrplefe. re d ne�s (nureer ar�e �set dA: mde) ` � o C .0 ,����7`d�.J Ai � � ` t- � ASSESSOR USE OliLY s I t'�k'i.�� i� c� � TiNJE�TAX �s 0.SSESSED VAI.UE � F100ffSTEAD� �"sr� NON�iESID6iT1ALs �` �'' .,.+2,.:''z ,!�!�....:.�un .r �r.:.a-�,� �X�'.:b.�!".tVALl1Ex � ..AT100%�TfV�t�,.FVALUE..�a.,�:�4,"k.rYS}'t;:;-.VALl1E�:..fit�,�«�.. ,., Land (rot e�¢eadng 1(one) aae imnadiately ' ` yy�rl��,�•�^�fy'� ���ti ?i�q4�5 !y��',xs surtamdingfBSidentialimpfovert�erlls. ( � .4Gvrx2�"�i".?`'�s"'� nK4i�9�s,�s�i.fa?' O�halard . �i::''i(t'' ' � �Z� , _,,,� ���.: ..', ;sa:;,. Td� lard (!'vie 1 pMrs fvre � �3) , ,�au+�v� ;, "'�` 7�i ResAenSal uflprovenL•nts orMnually ���9 �4) "�. ��rZ�,f'��' � ��*,asd'J.,`"R�,'+'��Y'�!+�.5.. _ � r. Assessed Mlodle / �Aarwfat�aed Flane Ga e �";v `��.i �'�'t� �+ 7�`' i` �i.: � �5) %�7{�'�iR�`�������rSO�b� p . i 4`;r �',i: ���ii����i$ �V� ',l� T�� .'..i�'�:i`:e Tdal'vnprovemertls (�vre 4 tivwyh 6ne 6) (7) Tilal value (I'o/e 3 pha 6ne � (g) I hereby oertiy tlie above is true. caietl. and �B�e of Mamsar Date sipad mrt�l�9. Vaifyirg eWon - Si�a¢ee of Au6�r Dalu signed N�'^ y :.t-s 'y, °-?: �°h,�.�<t":STMlDARD.DEDUCTION/iLLOWAMCE�..7 .ev.":.��' ��a�'' .�a''.....�l..;i✓'. -Y.. �"��F��i.G�`,G,+�?��# nr a^, 20_Pay20_ Lesser of 72 Hortcst�d V�uafian w 535,000 = � Si�twe d Pu�tor - Date s�red