HomeMy WebLinkAboutHomestead_Pinson� CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
t / S�ate Porm Sa73 (R6 / r-03)
Prescnbed �y Ne Department oF Local Govemment r'inance
INSTRUCTIONS: See revasC 5ide /oi 7ilinq insliucliquti.
y�(� " j FORM YEAR
I11� HC10
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��e) c fy hat o he s ay March, 20
I(VJe) occupied as our prindpai ce o( residence the following described real property tor which mes,�ad ro T C dit' hereby daimed:
❑ I(We) owned ❑ Are buying under wntract q�
� Have a benefidal interest in the entlry that is liable (or the propeRy taxes on lhe property and that ovms'tNe properfj oc �arwying under a contract.
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r.A*s-^-t. � �._..:+'.=`i r2' ���; _ s•.:.�,r -� n-:��..�"` CONTRACT�RECORDED�' , ...� . ...� � � .-:.:.s� . .
,x '
-- " . ... .. . . . _ . n. . � � �
II huying om m�traa, Fee Simple owner's name
Recordefs office where conVacl is recorded
Counry
I( any
otihe
Tamsnlp
Ja ���-vn I LMrxo�i.v���
1 ihe residentlal sWcmre or the Wnd not exceeding one (1) acre �hat
uWized to produce inmme.
Record number ( Page
ESCRIBTION?;; . ` :� ,. - - .�- .. -
T�cing dislritt (dty, tawn, townshiP)
Is Ihe v�Perty in Question:
❑ Real property ❑ A7obile Homo (I.C. 61.1-7)
i ety surtountls that swcture is used to D��uce income, desai6e ihe use antl pweion
' � �:'�-aY�-ti�..`« 3-a� �"i • �� � z.PROPERTYOWNED'��BYCLAIMANT�IN,OTHER'COUNTIES " " w ��fj., 'isa �
County Twvnshi0 Counry Twvns�ip
I hereby certi(y the above statements are true, correct and wmplete. i awre�l cl 'm�nt �
AOdre s umbeiand reef, 'ty,sfafe,Z/PCOdeJ
� �
����"x ����r'ASSESSDR-0SE ONLY' __ � . TRUE TAX ASSESSE� VALUE i HOMESTEAD NON-RESI�ENTIAL',
,?iir2-s. :.. � .:.. . . ._ _ ;•: � , . •: VALl1E � AT 100% OF.TTV - �. ' VALUE � �.<'�i3; VALUEz -•.; - �
Land not exceeding 1(one) acre immediately '= :•,�� =�;>^; f"'�". `- .
surrounding residential improvements. ( � � . -. ' ' - �
Ofher land �2)
Tatal land (line 7 plus line 2) (3�
Dwelling (4) � %"'�,�'' '_ '. ��
ResidenUal improvements orMnually ' `�"_`` �'�`'""�""''`�-"' r
Assessed Mobila I Manufacmred Home 9 (5� �`^;:i': ;::'; �`,-i�"' : .,
Gara e �� �>'
Other improvements (6) I
Tdal improvements (line 4 fhrough line 6) ��� I
Tatal value (line 3 phs line � (g�
I hereby certify Ihe above is true, covect, and Signature o( nssessor Oate signea
wmplele.
Vaifying actbn - Signature oFFwdibr Date signed
- ?s�-'C';z"-?=-..�." - - �STANDARD.DEDUCTIONALLOWANCE �
20 _ Pay 20 _
Lesser of 1f2 Homestead
vawauon or 535.000
5
Syna Wre ol Audilw
Date si� 9netl _
Y�
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