HomeMy WebLinkAboutHomestead_Rhoderick(�p�� CLAIM FOR HOMESTEAD PROPERTY iAX
CREDIT/STANDARD DEDUCTION
� � Siale Form 5473 (R614-03)
Prescnbed by the Department d Local GovernmeN Financ:
INSTRUCTIONS: See revasc sidc !oi /ilinq fnslruc(mns.
\,` J FORM
HC10
YEAR
; i�i< 1: " . :`. � =:' ' � :.;- ...�_�:�. � _ ,�.._.;-.. . - . CERIIFICATION STAiEMENT " . � -_..- " �" ,`, ' J'- � .
� e) certify that on ttR� �151 day 4i N�d� 20
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I(We) occupied as our principal of residence the following described real property for which a Homestead Property Tac Credit is hereby Gaimed:
❑ I(We) owned ❑ Are buying under con�racl ��,+�°!�
� Have a beneficiai interest fn ihe entity ihat is liable for ihe pmperty taxes on Ihe pmperry and that owns the pr�l�gy%ii�pgund�/a wnlraU.
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11 Duying on contraC. Fee Simple ownefs name
Remrdefs oifice where contract is rewrded
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Remrd number � Page
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Counry Toxnship Tacing dislnct (cify, town. mw hi
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Pa I r �^ /y� Legal description Is the Omperty i question:
�D/ J �-�Cl eal proDerty ❑ h7obile Homo (I.C. 6 f.1-7)
tl any porlion of ��a resitlential swaure w the Wnd not ezceetling one (1) acre that immetliatety surrounds �hat swcmre is uutl ro O��uce inwme, descnbe the use and ponion
ot the properry utilized ro produce inwme.
r �,,.-�, �. , �. :--. � -; .. .
�� ��* +�� '��ASSESSOR�USE�ONLY �_ � TRUE TAX ASSESSED VALUE ' HOMESTEAD NON:-RESIDENTIAC,
�."`.q`^'•j`l' � ;,e, x-^+:: ' VALUE AT100%�OF.TN- � VALUE . -�:,s.-VALUE��. -
_.,>u=.r .:�t., :°s:- . .
Land not exceeding 1(one) acre immediately I �- ..
surrounding residentlal improvements. (�) , - � .
Otherland (Z)
Tocal land (line 7 plus line 2) (3) I
Dwelling (4) %'�`�"' � . .. � .,
Residentiel improvements orAnnually '' ``''`'-'" �"""`"���°"�'�" �""� �
y�v --:r .- .
hssessed Mobile I Manufactured Home Garege (5� � �
Olher impravemenls (6)
Total improvements (Irne 4(h�ough line 6) (7) I
Tctal value (line 3 plus line n (g�
1 hereby certi(y the above is Irue, cortecl, and Sgnawre or Asseswr Oate signee
wmplete.
Venfying actbn - SignaWre of Fwdimr Date signed
- "-�-�ST/WDAR�AEOUCTIONALIOWANCE �
20_Pay20_
Lesserof t/2 Homesead
vauamn or E35.000
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