HomeMy WebLinkAboutHomestead_Straw (3)Art�' CLAIM FOR HOMESTEAD PROPERTY TAX
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''4-' " � CREDIT/STANDARD DEDUCTION
� .: > State Form 5473 (RS / 70-07)
Prescribed by the Department o( Local Govemment Finance
INSTRUCTIONS: See reverse side (or liling insfruc(ions.
�xq��. } :__ _ ... � ";'z:-.-71 � . - .. - GERTIFICAT
FORM
HC10
YEAR ,
�
I(VJe) � ) U�L� V '.�J�/t% certify that on the ist day of March, 20_
I(We)9tc p d as our principal p�ace of residence the following described real propeAy for which a Homestead Property Tac Credit is hereby daimed:
_/
J I(We) owned ❑ Are buying under wniract
�Have a benefidal interest in the entiry that is liable for the property taxes on lhe property and that owns the property or is buying under a cantract.
.�"c.,i,�'_-,v'�._"�:7'�`-_F. , �`� " 4�;' S�3.T �_? x z ., �G-'?. { ;';CONTRACT'RECORDED �:, - -� :?: �. .,r : ��a.� _ . .
If buying on contrad. Fee Simple ownefs name
Remrdets otfice where conVad is recorded Record number Page
Counry
7avnship
�ryrr/I n�'bjc /��] �^_ r� I Legal descnptio,ry�� � �� Is the propeny in queslion: -�� �� 1
JI�l UCTJ•.io� O V �7 ❑ R�ip,o�m y�7obi1 Ho I. iJ- ) J
I( any portion ot the resitlential sWdure w the land not exceeding one (1) aae that immedialely surrounds that sWCture is used ro protluce income, describe the use antl potlion
of the property utilized b produce inwme. J U I n O �oo^
L 11 O [
Tonnship
I hereby certify lhe above statements are true, correcl and complete. � Signanre
Land not exceeding 1(one) acre immediately
surrounding residential improvements.
Other land
Tdal land (line 7 plus line 2)
Residentlal improvemenLs
Other improvements
r1
l2)
(3)
Dwelling (4)
Garage (5)
(6)
Ta1al improvemenis (line 4 fhrough line 6)
Tdal value (line 3 plus line n
1 hereby certify ihe above is We, corred, and
complele.
(�)
I8)
Signature ofAssessor
signed
signed
�'-.��'�+r_�'��'k��._'� �.R�-f��..`�`i��:fs=.a"STANDARD:DEDUCTION'ALLOWANCE ; �.:r,�v.� .�:.nz-� .-.,:??s-r"�..�"�;=a� -.
20_Pay20_
Lesser of 1/2 Homestead
S
Valuatlon or 56,000
Sgnaturo of Aud�ar Dale signed