HomeMy WebLinkAboutHomestead_Schlottman (3)CLAIM FOR HOAAESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Stete Form SC73 (R6 / 4-03)
Presafbed by Ne Departrnerit af Local Govemmeni Finance
INSTRUCTIONS' See raverse side lor filing inshw.tions.
FORM I '� YEAR
HC10 �
I(We) " rr�:./V�� certify thal on �I�,}ytt�ypf�, 20
I(VJe) o our principal pla residence the following described real property for which a Homestead Property��i�C:r it�s daimed:
I(VJe) owned ❑ Are buyi g under contract
`' Have a beneficial interest in the en6ry that is liable for the pmperty taxes on the property and that owns the property r is b'gqj'n�nd re a conUacl.
If buying om m�Vaq, Fee Simple ownefs name
County
County
olfice where conVaq is recorded
Tamship
Tating df��Ert}(taw� fownshiP)
Record number � Page
� C` (�,,��� � Legal deuription I Is Ihe properry in question:
�^��+� `^Yl ' ' eal pmperty ❑ Mobilo Homo (/ C. 61 iJ)
of the residentlal sW dura or Ne land not exceeEing one (1 � acre that immeAiatey surrounds that sWCture is used b produce income, desai6e Ihe use and portbn
y uWized lo produce incoma.
I hereby certi(y ihe above sWtements are We, correct and complete.
(numbere�M street, city, state, ZlPcrodo)
not exceeding 1(one) acre immediately
mding residential improvemenis.
Other land
Tdal land (line 1 plus line 2)
�Residential improvements or Mnually
Assessed Mobile / Manufaclured Home
Other improvements
Dwelling
Garage
TUaI improvements ((ine 4 through line 6)
Tctal value (line 3 plus line �
I hereby certify Ihe above is We, correct, and
complele.
Veri(ying action - Si9naWre of /wdilor
(�)
(Z)
(3)
(4)
(5)
(6)
(�)
(8)
SignaNre of Assessor
ol
signed
Date signed
c�,�����:� ��n.b-«t3�i� t.�`�,`i''+�'��-xY:STANDAR�:DEUUCTION'ALCOWANCE.:,x'�".;�s�u�N �a?:'s�s':y'n,�^-'�� � -�'z"�`'�wz
20_Pay20_
Lesserof 1�2 Homestead
ValuaUOn w E35.000 S
Signature oflwditor � Date signed