HomeMy WebLinkAboutHomestead_Schrodt`'� ��"v
4� ; CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
t�S Sute Fwm 5473 (RS / 10-01)
Prescribed by the Depanment of Local Govemment Finance
INSTRUCTIONS: See reverse side for �ling insWCtions.
''wT�:,�c`".:��_ .'il.."s-.: ,...�5,"� . ,.- ._ . � 'CERTIFICAT
� � � RM jL�� � YEAR -{
��,
a JiJ
NOV O1 2002
� � � n /1
i� - . : r—� � �� .Z—�
��IRSO� COUr! i �' aUUi ��:, �
��e) y � certify' that on the 1 st day of March, 20_
I(VJe) occupied as our principal place of residence the Ilowing descnbed real property tor which a Homesiead Property Tac Credit is hereby daimed:
❑ I(We) owned ❑ Are buying under coniract
.Have a benefidal interest in the eniiry ihal is liable (or ihe property taxes on the property and Ihat owns the property or is buying under a wntract.
If buying on contraq. Fee Simple owner's name
Remrdels olfica where contract is recorded
Caunry
�
�.
Tavnship
W��-viaa7w iu��ncx.c��,��
i( any poAion a� ihe residentlal sWCWre w ihe land not exceeding one (1 � aae t�at
of the property ul'Jized to produce inwme.
rd number Page
_SCRIP.TION :•__ -. ?. .- 'i - -,..,, - .,'y';
Tacing disiric� (ciry, fown, township)
I Is �he property in question:
❑ Real properry ❑ b7nbile Homo p.C. 67J-7)
ialely surrounds thal sWCWre is useA lo protluce income. desai6e �he use and portion
' � »'t�,-ti��""���1 'p1-`" Y �'��� -. 7RUE�TAX z � � ASSESSED VALUE � .-HOMESTEAD � � NON-RESIDENTIAL� n �-
�
� ;����sxASSESSORUSs„ONLY � � x ,r j .VALUE- �AT700%OF'TN 'VALUE�" - ��"-� '��'�VALUE ��i`i�R' %i'��
a ,.s✓.?�.o-Y:.._ar. . [.s..`z� a.;s�.�.. � ,,3: : �.�rx, t .-.'+.1:._ vsE.ti.:
Land not exceeding 1 (one) acre immediately („ .�_;�� ��� �C �� `� kr ;� S }�` �.�
surrounding residential improvements. '� '; _s..,..-�rF�-1.�... :�:�r.E.--- ��-
�::. i ":.,;,
Other land �2) � -�- x �
_. �..
Tqal land (line 1 plus line 2) (3)
r `li° L �''tF�r 1?`xs. _'r
Dwelling (4) ' > � " � � .':,F'�'S�1-;
ResidentialimprovemenLS ' Ft �" �i"''�}z' "�'�"'y��.�.'
9 5 �:��r��#�v'�'',���`��t�����,��yi�;�:
Gare e ( �
'*i`.;.t�...rK..:"^�� ��'{'. �tiZ�. '
Other improvements (6) ; � �,k`��
_ � �,_
Ttlal improvemenis (line 4 fhrough line 6) (7)
TUaI value (line 3 plus line � (g)
I hereby certify the above is We, conect, and Signature o(ASSeswr Date sgnea
complete.
Verirying acl'an - Signature of Autlitor Date sgnetl
20 _ Pay 20 _
Lesser of 1Y2 Homestead
Valuation or 56,000
5
Sgnatureoflwtldw I / ^ ^ � 1 _U A, /1� /1 loate�sig{�a�
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