HomeMy WebLinkAboutHomestead_Parks,� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� �,• Stale Fwm 5473 (R6 / 403j
Prescribed �y Ne Department o1 Local Govemment Financr
INSTRUCTIONS: See revcisc side !oi lilinq inslmc(ions.
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-� � `�, FORM
`�� HC10
YEAR
v�.Y; - � ` ^ ��' � - ' :.l:tK �I IGATION STAlEMENT' - 4= .- ' " -
� �e) certiry on a(c _
I(W occupied as our principal place o( residence lhe following descnbed real property tor which a Homestead Property T�c Credit is hereby Gaimed:
I(VJe) owned ❑ Are buying under contract MAR 2 9 2005
' Have a benefidal interest in the entlry that is liable for the property taxes on Ihe property and that owns the property or is buying under a contract.
If 6uyinq on contraa, Fee Simple ownefs name
Remraefs oifice where convad is rewrdeC
Counry 7ownshi0 Tacing tlislrict (c��
r I be� O� _!� Legal Eescription Is the pro�
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If any po�ion o� the revdentlal sVUCWre w Ne land not eaceeding one (1 � acre �hal immediatety sunounds Iha�
ol the pmperty u6lized to produce inwme.
Record num�er Page
.".- -:Y" --� ' .
t ship)QO � �'
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in question:
� Droperty ❑ Mobile Homo (I.C. 61J-7)
Aure is used to produce income, desuibe lhe use ana portion
..�_x �_.. . ; ^t -...�: . . __ . . . . . _._, . r _ -... . ,
'x�'�:_ � _� � - P,ROPERTYAWNED��BY�CLAIMANTiN OTHER`COUNTIES- � ' ':� -�+ .�, t:�.�
Counly J Tawnshi0 Counly Tavnship
I hereby certify lhe above statemenls are true, covect and wmplete. Signawre ol claimant
�
d2ss (number aiM sbeet, dty, sfa(e, ZIP code)
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� � srt'l�;,ASSESSDR-0SE ONLY _ � TRUE?AX � ASSESSEO VALUE � _HOMESTEADty � NON-RES�DENTIACF �
_.�,�r. e.../'ti�.r �_�:"i . :..�^x-.-�. .: . _` _ :: - `' "VALUE - } ' AT 100°b�Of'TN �.., ' VALUE - �. u; VALUE:? _
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Land not exceeding 1(one) acre immediately -+ �-=r' �- � '.
surrounding residential improvements. (� � . - � - �
Otherland (Z) . .
Tqal land (line 7 plus line 2) (3)
Dwelling (4) .+ ....-,i�, � _ .,.. -- •
�F :rJ
Residentlel improvements or Annually "
Pssessed Mobile I ManulacNred Home Garage �5) f� �� .
_ ��,r,�_'.,�:..-.
Oiher improvements (6) -
Tdal improvements (line 4 Ihrough line 6) (�) "
Tdal value (line 3 plus line n I(g)
I hereby certify the above is lrue, cortect, and Signawre ofAssessor Date sgned
complete.
Venfying actwn - Signature o1lwtlitor Date signed
20_Pay20_
Lesser of 1l2 Homestead
vauauon or 535.000
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