HomeMy WebLinkAboutHomestead_Pollock (5)�, CLAIM FOR HOMESTEAD PROPERTY TAX ��
' CREDIT/STANDARD DEDUCTION f
/ SuteFwmSd73(R6/l-03) �V\
Presaibed by Ne Department ol Lacal Govemment Financ= ��
INSTRUCTIONS: See �evcrsc side !or Iiling insf�ucGnns
FORM
HC10
YEAR
y
��e� � certify that on the 7 st day of March, 20_
I(We) occupi as our principal place oi residence Ihe following described real property for which a Homestead Property Tac Credit is hereby daimed:
I(We) owned ❑ Are buying under contract
Have a benefidal interest in the enliry that is liable for ihe property taxes on the property and that owns the property or is buying under a conVact.
If buying on conVaa, fee Simple owners name
RemNers olfica whma ronVad is remded
��s�ay��,.^a."',.Q�'-.�.��x.�,�.�a'"�. Es�v" �-.�� .
County Tawnship
H any porUon o/ the residemial sW cture a the land not
ol Ne property utilized m produce iricame.
) acre that
Record number � Page
Taing di c' , town.
, . Is the orooertv
�Real property ❑ Mobile Homo (/.C. 6/.7-�
Nat swGUre is use0 to produce inwme, deuriba the use and poribn
'+*� � � ='�1.? ' _.�... xl. —_—_' _ _ ' ' ' '_ _ _ " _ __' _ _ '
•:�-�..,..'��rF-�'�- -�'�""'-"?r��:>��a�atPROP,ERTY;OWNEU;BX;CI'AIMANT,IN OTHER'COUNTIESFr� ,�'��:�,3'�irz,:�".�,'�'u'��l'r�."?=�,�.`%A,�''._'x�'
County Toxnship Counly Twvnship
I hereby certify lhe above statements are W e, corred and complete. Signature of claimant
�dreu (number aiM street cily, state, ZIP code)
.L.zy�' f + C""+.�r.' Ya2"r�''�"7., y, y"y`"�,ht �?F' �' . ' % . . %.-""�"` 6.g-'-r _ . '
�ASSESSOR�USE ONLY � � YTRUEFTAX ASSESSED VALUE HOMESTEAD •' "�k�'NON`RESIOENTWL �
����� ' -.:.k�:tR.�'iAk&3:�-�'s'g�.t`., ..:.�*��`��-.t*s�..�i"c;�? �VALUE.X-�.�, u� �AT 100Ye OF-LTfV� �E;VALUE�:.S�• �e.�"'�•-�`�VALUE�-�'v.`�^''��`,'y�'�``,
Land not exceeding 1(one) acre immediatety ��j �;�r.�t<-��,� �� ��,'r�
surrounding residential improvemenis. (� � : ��'<',�'�����'°P�' � � ��' � ;�'
�.?, �;x
t'E�.��`�+'.;`"�.�r -L.-r.�-. � .
Other land (Z) ���� �
��W,x �
Tolal land (line 7 plus line 2) �3) �
��'.; >.c �o, _"�
� � � `3:x aa ,.
Dwelling (4) °i .y.c%fry-�q��: � -5� 7?s
Residential improvements or Annualy
��4 �swiv°^f�.'h.3!'t� s�.!- "�iy�l i'+'�
Asseued Modle / ManuFat4ned Home 9 �5� -�-��,`k .�.h -"�"' c-
Gara e ��t �,����.'��,rf
�e�+�wr�',�-,h �'.'a X�.�"u'
� :#�:;�!�is`.. �,s
Oiherimprovements (g) �{��,�� '
:°�}�a: 5
Tdal improvemenfs (line 4 through line 6) (�)
Tdal value (line 3 plts line n (g)
I hereby certify the above is W e, corred, and Signature of Assessar Data signeA
complete.
Vrrifying aclion - Synature oflwditor Date sgnetl
�a�"�.s�.�-`�'��t.����s!���.at��'� �=`STANDAR�:DEDUCTION�ALI:OWANCE�,..:x,.'�-P'J.'^..�'.�cukL.a'x'-�it�; `1`.,.u� s`.'�-,��---sYj"`. .
. _ _3ec: �Y�Ar'''4� ��V-�r rr.ti s
20_Pay20_
Lesser of 1/2 Homestead §
vavauon or E35.000
Sgnatuw of Auditor " Data signed