HomeMy WebLinkAboutHomestead_TalbertCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
'; CREDIT/STANDARD DEDUCTION HC10
/ SL�te Fortn 5473 (R6 / 4-03J
—_�` Prescribetl Ay t�e Department of Local Govemment Finance
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INSTRUCTIONS See reverse side /or liling mstmcfions �
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��e) � certify that on thellNt day of March, 20
I(W occupied as our principal place of residence Ihe following described real property for which a Homestead Pro� Tac Cr� is liefeby dat' ed
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I(VJe) owned ❑ Are buying under contract y J; ,-v M� J T0� •
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� Have a benefiaal interesl in the entiry tlial is liable for ihe property taxes on the property and that owns lhe property oiis buying�under a wntraU.
If byvg on conVaq, Fee Simple ownefs name
RecoNefs ol6ce where conVad is recorded
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County Tomship
Parce umber L I description
�1�-63791- cn t�n,,,-,..,
H any po�ion ol the residential sW cwra w thdland nd exceeding one jt ) aue
ol the property util¢ed to produce ifrcome.
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Ihe property in question:
� Real property ❑ Mo�iia Hwno (I.C. 67.7-7
wnounds Nat sWCture is used b produce inmme. describe ihe use and portion
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20 _ Pay 20 _
Lesser af 1�2 Homestead $
vauanon w 535.000
Sgnatura ofPud'Rw ' Date signed