HomeMy WebLinkAboutHomestead_NalleyCLAIM FOR HOMESTEAD PROPERTY TAX U�
CREDITISTANDARD DEDUCTION ��/"
State �arm 5473 (R6 / 4-03) ��� "
Prasaibed 6y Ne Departmein of Local Govemment Finance
INSTRUCT70NS: See rererse side /or (lirg insfi�clions.
d
FORM
HC10
`�
YEAR
��e) L � � ceAity �hat on lhe 1st day of March, 20_
I(We) occupied as our p n'pal piace of residence lhe following described real property r which a Homestead Property T�c Credit is hereby daimed:
❑ I(We) owned ❑ Are buying under wntract
� Have a benefidal interes[ in lhe entity ihat is liable (or the property taxes on Ne properry and that owns the property or is buying under a wnVaG.
II buying on conVaa. Fea Simple ownefs name
RemNers olfice whera conVaU is recorded
County
Tamship
�
oi the residential sWCWre w the land not exceeding one (1) aae Nat
y ulilized tn produce inmme.
Rewrd numDer
Tacing district (city, town.
Paqe
� Is the properry in question:
❑ Real property ❑ Mobile Homo (/.G. 67.7-�
surtounds ttiat swcture is used to produce income, desrribe the use antl portion
�,���'```ASSESSOR�IJSEONLY v'"���w��:' �TRUETAX��n-ASSESSEDVALUE��HOMESTEAD3�'� �v ON N=RESI�ENTIAL��m�s
a.�. e�:s�.�C �.� .:> +" . ,�,�`�'=c �. . ?�i�:f5�%�,:.. �'Y...VALl1E:^t .,yt` .AT'100 /e OF TN.�i. ++.'° t'pcVALUE..�-.��.`" ��a VALUE�'� ��
Land not exceeding 7(one) acre immediately 3`� � 3i� �}, '�`
suvounding residential improvements. ( 1 °�,� �'�'�' ';�'
� �� s. �a «.+'2x�ir z�.7���`.
Ofher land ( � �`���� `�..`�,-1'�
Z r:..- k�.. � �
' �:D .i;
Tdal land (line 7 plus Irne 2) (g�
Dwelling (4) .' �`�"`��i`;*`'i`��4u._.� s
2 c�'�'•
�Residentiel improvemenLs or Mnually ���������'� � ����
Assessed Mobile / Manufadured Homa Garage (5� �'�'��: �� "x'"`� '�} �t.�
a q�
r�.�.?-i � : "'c,.�3'c:sYa.t.S?:x�tt_'*2-
Otherimprovements 5 c..� ��'� �'�
( ) f �=�'s�"'^.�;.�,�
Tctal improvements (line 4 through line 6) (��
Total value (Gne 3 phs line n (8)
I hereby tertify Ihe above i5 We, corred, and SignaNre ofAssessor Date signed
complete.
Vrrifying aqion - Signature otlwditor Date signed
"'�a'�.}��;�e?.`,�.�T"���"'4'`'°";�,';,�.'��'Jn.��^`,`..'��STANDARD:DEDUCTIONALCOWANCE ��?�`..�'•-.r,.�''e�`L��'a-_$,:,�,�att�^•w� t" +:. `'.'�`�s�-...'�''.�,�
- 20_Pay20_ '
Lesser W 1/2 Homes;ead
vauauon w 535.000 S
SgnaWraofFwditw � Datesigned