HomeMy WebLinkAboutHomestead_Phillips (2)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Slate Form 5473 (R6 14-03)
Prescribed by the Department of Local Government finance
INSTRUCTIONS: See reverse side for filing inslnictions.
3 `s•- .? *"- -?,,;e ,- r, '"/x�i"== { : "`_.CERTIF�ICATIOONN STATE NT.7;;
I (We) TI
L10 �F— 0A /X iI .Q._ / ;
I (We) occupied as our kgncipal place of residence the following described real property for which
❑ I (We) owned ❑ Are buying under contract
�d
FORM YEAR
HC10
a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded
'Mat 8Meftb 41k4eyA469ch, 20_
Property Tau Credit is hereby claimed:
JAN 0 4 2005
or is buying under a contract.
Record number I Page
?f`Erry?."*r�3,r� r+`,.!^`Fra: r .-i' 3 9v+.- vss..- __ - - '__.
;., _. .� -.,.r. .- 3 .ti :t-a :'ter' - s'.., -:s- — _U0ROP.ERTY, DESCRIPTIONS
County LY
Tmnship
Taxing district (city, town, townsh'
)
P
`nymbe
1V-11
Legal description the roperty in question:
Signal of clahnant T -
ress (number aM tree4 ci0: state ZIP ode)
3/d _. &vi
Real property ❑ Mobile Homo (I.C. 6- 1.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately suffounA that str6clure is used to produce income, describe the use and portion
of the property utilized to produce income.
dG -/.3- 0 9- 00.5�
ytr `s 6'" "'F ` _' '�"� -`•'' -W
•�' jyS¢f", §.ASSESSOR'USE ONLY�(y�5c
P, ROPERT' Y, OWNEDBYCL '`AIMANT'IN'OTHER'COUNTIES v's- .r+�'+''."�°„' ^D. 1'� '4 r^r � 'c''=
County
Township
NON- RESIDENTIAL �'
5
County _. Tmnship
I hereby certify the above statements are true, coirect and complete.
1`AT.F700 %'OF'TTY
Az .�., a .n .+.� r1sT..c arf�
Signal of clahnant T -
ress (number aM tree4 ci0: state ZIP ode)
3/d _. &vi
iAJ V76 $1
ytr `s 6'" "'F ` _' '�"� -`•'' -W
•�' jyS¢f", §.ASSESSOR'USE ONLY�(y�5c
= a-�fRUE TAX f
ASSESSED VALUE
HOMESTEAD*
NON- RESIDENTIAL �'
5
�YSr ^F . .Tim`ix-t,'."...s'a- `+S•+
VALUES.''
-_.... �c�`.+.
1`AT.F700 %'OF'TTY
Az .�., a .n .+.� r1sT..c arf�
rVALUE £"
-�. •r...i�r
!� •VALUEa" +`3`
Mrlr'�J,rYr..... .- .,..di
Land not exceeding 1 (one) acre immediately
1
O
Mt'
" x 4 �
�r
surrounding residential improvements.
,�� ✓._�� n, ..
Other land
2
Total land (line 1 plus line 2)
(3)
Dwelling
(4 )
�,as , ,
g� a + a
AM
ON
Residential Improvements or Annually
MobOe I Manufactured Home
Garage
''�'
(6)
Other improvements
(6).'x
-3'"ri'
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line n
(6)
hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
:ST/WDARD'.DEDUCTION'ALLOWANCE
20_Pay 20_
Lesser of If2 Homestead
S
valuation or 535.000
S' re of Aud
Date s" ne0
r -�