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CLAIM FOR HOMESTEAD PROPERTY TAX
^ k CREDIT/STANDARD DEDUCTION
` Stafe Fortn 5473 (RB / 7-07)
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Prascnbed by tha DeparlrtreM of Local Govemment Finance
INSTRUCTIONS: Ses reverse side (a filing insWctions.
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I(We) certiry that ono the 1� oi
I(VJe) 'ed as our prindpal place of residence the fdbwing described real property fw which a Homestead �mp�rty�'�'aC(��i� 1
I(We) owned ❑ Fve buying under contrad
Have a benefidal interest in the entity Mal is IiaWe for the propeAy faxes on fhe property and that ams tlie property or is buying under a contraG.
If Wy"u�g on oontraq, Fee Simpie v.vnefa name
Recordera office where
Counry
Twmship
town. lownsAiPJ
Rewd number � Page
Paicel number L I descnplio�n% •�(i Is �he
W /�" /}GI WWeKYinqueslion:
�T %V d /D ❑ R�� �m � M�� �,,,� c�c �-,.,-n
If any portion of lhe resideMial sWCture a ihe land not exceeding orre (1) acre �hat immeAiately wrtounds that sUUCture is used b produce'vicama, tlescribe Ihe use and porlion
of �he property uliGvd lo produte inwme.
a�-��-��- �03- �o.�. �9�- o��
.. . . . .. . ,
,, .
Land not exceedi� � (oire) ave immediatey -r '{.+ . ` - _ .�
surroundirg residential improvements. ��) '' � .. ` ..�;=� �� `-: =;: . � ` �:: -# �.: ,•
Other Wruf �2) �""j "�.1: `�' -
_ y.-:_;u.Fi.. :._.
Tdal land (line 1 plus line 2) �g)
y� � ;.. � s
Dwellirg (4) e '� ' � i-; < .x•'Y. �..
Residential improvements or Mnualy „t � .
ilssessed Mobile I Manu(acWred Home ;-��:�,-,. <:+_ ,4,�?.F � ��:-.:. .�: . �
Garage (5) n s^,r,> �r; ;, .
r u,,` '
Oiher improvemenfs (6) :�";`,'' ,
i;'_
7ctal improvemen4s (line 4 throuqh line 6) �7�
Tdal value (line 3 plis Grre � �g�
I hereby certify Me above i5 We, Wrrecf, and SigraWra of Assessw Date signed (mmth.Oay, year)
cmnplete.
vatyi�¢ ewon - sgrew�e otnuai� oa�e sre�ed ���n. aay yea,�
20_pay20_
Lesser oi 12
Homestead Valuafion
w
Signature of �ta
45.000 for 2007 pay 2008 42,000 for 2010 pay 207 7
44.000 for 2008 pay 2009 41.000 for 2017 pay 2012 S
43,000 for 2009 pay 2010 40,000 payable aRer 2012
Da�e signed (mmN, dey, yee�