HomeMy WebLinkAboutHomestead_Kittle�
^ CLAIM FOR HOMESTEAD PROPERTY TAX
� .�� STANDARD / SUPPLEMENTAL DEDUCTION
State Portn 5073 (R72 / 6-09)
�O , Pmsnihed �y the Department ol Local Govemment F�ance
(NSTRUCTIONS: See raverse side tor fili�g inshucUons.
�.�� ' ;�
'��[�'_
NOV 0 9 2009
��
YEAR
..
I(We) certity tha� °�°'�"� my (our) prindpal
place of residence or am (are) buying the following described real properry tw which a Homestead Properh�fTas St�n��AU� 14fi Y daimed,
under ct on �he date ihis applinlion is filed, (date ol filin 4 Bg0
9)
(We) own ❑ Am (are) buying under recorded contract
❑ Am (are) enlitled to occupy as a tenant-stockholder o( a cooperaUve housing corporation
� Have a benefidal interest in the wst or the right w occupy the property under the terms of a qualified personal residence Wst
•• • •
N (da" nt(kgal a ) •
SotialSeamry '
Name o( tltimani's spouse (lepal name)
" Sodal Seamry numbel W tlaimam's spouse (last frve tligrts) OrivrYS lernse / Idrntlfration / Otner numCer Isw4g State
of da'vnam's spouse (last hve dg2s)
• ••� �
If buying om m�tract, Fee Simple ownefs rume
Reooidefs o�6ce where conUaG is recordetl Retord number Page
..�. . � . �
�nry Twmship Tarirg disvid (ri(y, roun, township)
6. r al esai on Is Ne property in qu�fion
� �•� ❑ Real property ❑ MnuaOy assessed rtpbile home (IC G7.1-7)
�of f Ne p�iope�itya NuN¢ed NeproduCB 4�come. ���t exreed4g wre (1) aae ihat immediatety surtoumis ihal sW�re is used to produre Inmma. desrnbe ihe use aM porbon
�i� �a,�'
... . . : . .
Counry Tovmship Counry � Tawr¢Np
I hereby certify the above statements are We, correG and complete. Sig�wre ol � • �
AEGress(wm6erand f,dry,5fate,ardLPCOtle �, � �
� • • � • �
� • i�'. •
Land not ezceedi� 1 (one) acre immediatey �T ""�y�"* +��`�` `"�`� «,� �'�� =
surtountlin residentialim rovements. (» �^�-°r�'�:4i� �.:�y
��_'- '" �?'
Other land (2) ". �<�iiz ��.':fi=.°.-
ToGI land (line 1 plus line � (3)
��ts� � r �.,,r.�; ��
ResidentialimpmvemenborAnnualty �"'ellin9 (4) a.�-� � �i�4�a ''t+n .:?�+':
Assessed Mobile 1 Manufactured Home � '"� '�°sx` � a kn'� >" ""�
Garege (5) -i-'.ar,�,�� �:F:;.�n,.. .'S'��
:i';.,�:=.'r:...�,�n<Sa-.�..� '�,�`e�.."-';t'4='»'�
�. � :
Other impmvemenn (6) / c � ��."�c+. >,
Total Improvemen� (Ilne e Nrough line � (7) .•
7otal value (line 7 phs Ilne 7) (8)
I hereby certify the above is true, correct, ' Sigriawre oiPSSessor Date signed (month, tlay, yea�
and complete.
Vaifyuig accon - Sig�ture of PLditw Date signed (rtronN, day, }ear)
� . • � • � • •
20 pay 20 _ Lesser of 60% of the assessed value of ihe homestead or $45,000 "
AbrtuilhstaMing any olherprovision. Ne sum o/ lhe tletlucObru pro�ided in IC E7./-12 ro a rtrob�la Mme lhaf is $
rwt essessed as real properry ar fo a manufaUUred home Nal is not assessed as real pmpeM msY rwt erreed
onMall (72) o/ Na assassed rdlue W the mobde �ome w manutafturetl hame.
Sigrature W�tnr Daie signed (month. eaY. Y��