HomeMy WebLinkAboutHomestead_MatthewsCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Slete Form 5473 (R6 / 403)
Prewibed by the DepaNmiri d Local Govemmerrt Finance
INSTRUCTiONS: See iewr�e sddi b(�p insbuMions
FORM
HC10
V
Y AR
I(We) W YW1QJlA.R� I 1 I(.�fl,R.ldr(�, certity that on��tu 1iy�yy�(�rch. 20
I(We) occupied as our principal place of residence the following described real property for which a Homestead Propertp�rmc �t it (s �teby daimed:
❑ I(We) owned ❑ Are buying under wntrect '���� �
, Have a benefidal interest in the entity thal is liable (or ihe property ta�ces on the property and that owns the propertj/of (S�+�ing u�r a wnUact.
1( huying on conVaq, Fee Simple ovmers name
Remrders olfim where con�racl is recorAed
Counry
Toxnship
v � l UVJ�%V -f%� � � \"{.�O!/M �
1/ any portion ol Ihe resitlentlal sWCWre w �he land na enceetling one (1) a�se
ol lhe properry utii¢eA to produce income.
Record number
7ating tlis�rict (ciry, town, fowruhip)
Paqe
I Is Ne property in puesUon:
❑ Real Dmperty ❑ Mobila Homo Q.C. 67J-�
wnounds Ihat swcture is used to produce income. desaibe the use antl portion
c,,. g� � +.' �%�.:�"�-�c3�P�t�'-�'3.�5 +�i f �'' e � . � e
�-w` �ASSESSOR�USE ONLY�� ���� �� AT�E00%OFTTV � H�VALUE�y�� ��"�ON;RESIDENTIAL zq a'_'
3.� .�r.'aT�°rs".zt.r�;T''�L`,.-'?-�#�.��,�� ¢�.-+.._. _ .._Y. .'.t �.r -...r��".s' �.-�. r,::�1:F�a VALUE'i's.� a.
Land not exceeding 1(one) acre immediately � �3'.� +�� "'i-� �i *�� �`�'*=;
surtounding residential ImprovemenLS. ( � � � "��' T'� �`�"�
rp
. �-. .t:� 7:.s�<.i'^",�.'�a �<
Othe� land (y) ��g�����,.�
�.�'°�,z
Total tand (lina 1 plus line 2) (g)
Dwelling (4) ����� "tr����
�Residential Unprovemenfs or MnuaDy '� ��"��"44"�
Assessed Ab6ik / ManufacNred Hane Garage (5� � .'��� .x���8= �s'"'�3� � x
�ev'��uc���_'.�4'�" v''*{��
�.M.tiwar�� _ >
K: . �'~i
Otherimprovements (6) �r,��=fiF; �� `.
�v .�t.
T�ial improvements (line 4 fhrough line 6) �7�
Tolal value (line 3 phs line n (g�
I hereby certify the above is frue, corred, and Signature of Assessor Date signed
complele.
Veri(ying actbn - Signature ofAudimr Date signe0
'�.� -:�'�'? �:mi�.^r�'�-'"_�b°�`s�`��-y#�,ST/WDARU;DEDUCTION•ALLOWANCE'a� �;,`�, '�'i�.�^�"`.5���'r,7�;i+'� � �'�r�.�-; �?,�'sF
20 _ Pay 20 _
Lesser ot 12 Homestead
vawahon or 535.000
S
Signature of Audri« " Date signed