Homestead_StilesCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
` Sate Fartn 5673 (R8/ 7-07)
u� Rescnbed by Iha Departmenl o( Local Govemment Finarxe
INSTRUCTIONS: See reverse side /or filing ins6uctions.
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FORM YEAR
0
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I(VJe) �_C!!.� C. .�L�GCl� certity fhat on`�7st day pf March, 20
I(We) ocapied as our prinapal place of residence the fWbwing described reat property for which a Homestead Property T�`�I�s{�by daimed:
�I (We) owned ❑ Are buying under contraG QIB96N @pUNfiY qUBIF6p
Have a benefidal interest in the entity that is liable fw the property t�es on the property and fhat owns the property or is buying under a contrad.
If buying om m�tract Fee Simple amefe rmme
Recordefs of5ce whare conVad is recaded
County / TwvnsWp Tai (Cify, fown.
Paul number l p� � I Is ihe praperty
rc arry p«tia of residerrtial swqura w the WM na exceedirg one (7) acre that un�atNy su�unds smx
d ihe prope Zed b produce inwme.
ra�G-/a-��' /a�- ooa. �'i�_aaa'
cuaory
Tavnship
I hereby certify Ne above sfatements are We, correct and compiete.
(number arM sLeeC dty. sfate. end LP code)
F7
Recwdnumber �Page
al propeM ❑ Mobiie Fbme (IC &f.7•n
is used in produce tr�mme. deuriDa the use end ponion
�_ � � • .� • �
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Land nol ex�rg i(orre) aae immediately �; �X? -r.�£syy � i`+`;, .�
surtoundirg residential improvements. �� � � - � '
��..• -:;bi: - �
Otfier iand (p� - � `.--� _. �.
Rtal Wnd (line 1 plus fine 2) (3)
Dweliin9 �4) :u �� �; � �. ` ,M��� �•
Residential unpravements a Mnually '_ if,,.i �; u; x,� ,. ��•
AsseS58d Mob�le I ManufaC4ired Fbme � �h ,,,.? R,n ".. s'a ��.
Gara e �. � -�C"�-'•L i.�.. � w.�, r.
9 (5) t ��..Wf
'i:ti�'�:k �',`f:-�wt..''r.�i_'`
- -•13^t i:F::
Otherimprovements (5) »-..c :s: �-N'"✓ -}
Tdal improvements (Gne 4 thro�gh line 6) �7�
Tdal value (line 3 plts liire � �g�
I hereby cartiry the above is We, corred, and signature otAssessa oate signed (monfh, day, yea�
canplete.
Vaiiyirp adion - SipnaWre of Audibr Date 5igned (manlh, daY. Yea�
�.•� � � • •
p P�' Z� — qs,ppp tor 2007 pay 2008 42.000 for 2010 pay 2071
Lesser of 12 qq.000 tor 2008
Homestead Valuation PaY 2009 41,000 tor 2017 pay 2012 $ .
a 43,000 tor 2009 pay 2070 40,000 payable after 2072
signaWra of �br Date signed (month. dar r��