HomeMy WebLinkAboutHomestead_VelaCLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
Stete Fortn Sd73 (R6 / 4-03)
P�esriibed hy Ne Departmem of Locel Govemment Finance
iNSrnucnoNS: saa .��,� � �, rr�y ��n�.
FORM M YEAR
HC10
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y.%t5"...=�.u'i::�3 ;:'..�r;.%S4Ti�'' i �'sY-4-'"ist� -�a-s?s.:xx �:_��I:tRTIFlCATION STATEMENT r _ ��..�'��'- � -�;' "'t:yt�'+'�c4�.*'_: ...:; .�: -
_�e) . ` �.__AR � —
� certi(y that on the 1s�da8y oTMa ch, 20_
I(We) occupied a ur principal p of residence the following described real property for which a Homestead PropeK�j� Credit i,s� !he�reby daimed:
❑ I e owne ❑ Are b ���� ��+-�
(N� ) uying under conlract v
, Have a beneficial interest in fhe en6 that is liable for the ro e taxes on lhe ro e p�Bp 7lyN �S�i�Tny ��iT(}�nUact.
�Y P P rty p p rty and that owns the ro e o
If buying om m�trad. Fee Simple ownefs name
Remrdels ofice where wnVaq is remrded
:�43��-.��.4`�ti.-�T`f`��::A:�ix_�-�'_.`� w�'�.+''Fi�€�;
County Tavnship
Tacing tlislric� (uty, fown, township)
Rewrd number � Page
Parcel number �f [�� Legal escri tion Is the property in questian:
�,� � O�1 I U l•VCJ J� �il t�Ph v i ,� ❑ Real propeM ❑ Mobile Homo (I C 6f f-7)
If any portian ot Ne revCenUal sWCture w the Wnd not exceeding ona (1 � acre lhat immediately surrounds ihat strucWre is used to produce income, desuibe the use antl porlion
of the property utitized to produce income.
o� / -�h?-Q�- °y 1.� -� • /F5� - aa �
Counry
Tavnship
I hereby certify the above statements are We, conect and complete.
dry; stafe,
County
Township
�Y^+cs }�i'i <fT S . -. _ v +T . R i tr'SS . . ,! . . . V ..y . .
, �!.��'' u `3'- - ' "' � - � TRUETAX'�-�� ASSESSED VALUE � HOMESTEAD " NON=RESIDENTIAL v
{�� � #` F A�SS,ESSOR� SE,ONLY t . �{t'� . - � L�#VALUE="'� � : /iT 700%.OFiTN �- i'� �' '�+ �• *t'+. `�}
�� ..,
., � �-.N a v,-, `r ___.� .._ . .... ._ 1� .. ,-�,....... � +t+�., VALl1E.Rr� ��u.d- � '°�YALUE� s„� ; .:
Land not exceeding 1(one) acre immediatety '� ^` ,'��". m. �� �
surrounding residential improvements. (� � ��„��,������ ���= t s�
.�. «?��CC. �",R+u"�' �',�q-�t
Oiher land (Z) a �`. ��� ,�`� ��
"��.� �SPt'��
Tdal land (line 7 pfus line 2) (3)
��„�, s..'��'y ''m�v��..a�
Dwelling (4) � �.�:'`.�.��s�',`�.,a ���'„
�Residentlal improvements or Mnualty S'--�"'"}`"'s`�' �"� L s`"
0.ssessed Mobile / ManufacNred Home Gara e � ����� s%'a�"` �
9 (5) �'������`a�� �� �' �
- n3�,`°,T%Y ...:. e�=
Other improvements (g) ;�'�����"�r`�y-y�'�� ^� ��
, �. ;ip4. �`�' 1'�£�'t-'����
Tctal improvements (line 4 fhrough line 6) (�)
T[fal value (line 3 plis line n (g)
I hereby certi(y �he above i5 W e, cortetl, and SignaNre of Assessor Date signed
complete. �
Verifying aclion - SignaWre otlwdiWr Date signed
'- --" ...>k+�. -.� - ._ _
..c�-c'E'^�R��' ��„��3P�a�:`�3c.��,�.�`''`���`sSTANDARU:DEOUCTION�ALI:OWANCE "^' � ' '
�— i'."��.�-`:�:�ve��P�fu�s,�i�'s,- �F.''�"a'�a�� -`r�%�u.�,
20 _ Pay 20 _ -
Lesserof tr1 Homestead
vawauon a 535.000 S
Signaturo oflwditw � Date signed