HomeMy WebLinkAboutHomestead_McEllhiney (15)""' CLAIM FOR HOMESTEAD PROPERTY TAX
;, _.. s STANDARD / SUPPLEMENTAL DEDUCTION
State Fwm 5473 (R12 / 6-09)
�' � Presa;tm ty u� oepartmem m�i cover�eM F�mnce
INSTRUCTIONS: See ieverse side lor filing
❑ Am (are) buying under recorded contract
❑ Am (are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation
� Have a beneficial interest in the Wst or the right to occupy Ne property under the tertns of a qualified personal residence Wst
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Name oi da'unam (�eger name)
Sadal $ecvriry nimCa of da'crent ( Drivels Iicenx I Identifxation / ONer ��� Iswu�g {(\
of daimant (lest frve d"qiLV) I L�
Q%V \
Narn f daimanYs spouse (legal name)
Sodal 'ry numba ot tla4nant's spouse (lasf / Identifration / ONer number Issu'vg e
af daimanCs spouse (lesi five Sgds)
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tl buWi9 wi con120. Fea Simple ownefs riame �
Recorders offxe wherc mntrad is remrdeE Recdd number � Page
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Counry Trnmship Tamg G�sbiG (ciN• town. townshiP)
P num r /�/� Legal desaiP� Is Ihe properry in Ques6on:
6 (% � D''� W` �s ❑ Real yoperty � MnuaAy assessetl rtmb�e home (IC G7.1-7)
�tt any portion W tha fesldential sWwre or Ne IarW nol exceedinB are (7 � atre that immeEiateJy surtountls Nat sWCLire is used W Produce Uioome. AesWbe iha use aM portion
of the P�PenY u�Tari to P�uce income.
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Counly ib.m5hip , Caunry 7own5tup
I hereby certify ihe above stetements are we, correa and complete. ��"a�`� �
Pddress(num6eraMahce cify fet ntlL e) . . .
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� � . � • �
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su uundmx�m,x�ide tialim�r�o emen�diatey ��) �.�����;,,4�}������
Other lantl (2) � �^:� �.��-,��-R;• .
�,. �:
Total lantl (line 1 plus line 2) (3) �
A
Residential improvemenb or Mnually �Ilin9 � (4) ���'�� ����_.?��.��
Pssetsed Mohik / Manu(actured Home '�¢`-"+ ,y .p,F `r:: s€:S�
Garege 5 ��`�i .� � - �
( ). �c�, :t>F3i't a.3i °Y .a �s w�'"�r- �'�
Other improvemenb (6) � � :���Y ��� =�
� �.�..�;�e�
Total Impmvemen� (line � through Ilne � (7)
ToGI value (line7 pfls Ilne � (8j �
I hereby tertiy tha above is true, cortect, Slgrawra atAssassor Date signed (month, day, yea�
and complete. -
Vaih�irig actim - Sig�one af Putlitw 6ate signed (rtronN, day, yea�
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20 pay 20 _ Lesser of 60% of Ihe assessed vAue o( ihe homestead or $45.000
Nofwit2Vard"ug eny otherprovision. Ne sum Nthe dedcctions providedln IC b1. f-f2 to a nroW7a frome that k $
messezseeesrea�aoaemwfoemenutarn,rednorneNa�araressessedesrea�v�aam�r�,oterceed - -
one�ha9(f2) oIlha assassed vE/ue o/ Ne mo6de home wmanufactured hortie.
Sig�aWreofNWifnr ^ ' Date neO( th day,yea�
li'� �g •�b—1 l