Homestead_Wade�
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�'�CLAIM'FOR'PIOMESTEAD PROPERTaY�TAX;��;_��y�7___�.-=j,="' -FORM- —
- CREDIT/STANDARD-DEDUCTION = -- = - � - HC -
/ Sla�e Fwm �a73 (R6 / 4-03)
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, Prescnbed Dy �he Departmenfol Locat Govemment Fnznca '
j INSTRUCTfONS'See'rev'crse"siile�lo'r`fY�ig'insfnicfiniii"''9� "�•'r''r�".�',7��l�-- ,^ � ; �' � - .-
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YEAR
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�I (We) ` `�'-� � certify n� st day M , 20
;1 (We) occupied as our principal place r sidence the following described real property foi whicti a rt� r eby daimed:
�t t ��� � nA � �. r., . . a r e A r . n —a^ t , . •. . � � � . . . �.0 ITOR
❑ I(VJe) owned Q�Are buy� under contract ' '� �
�I -zao�o4� � x.TCZ�s o��n nn.���;r�h -�.� a;. i� 3�m _ , r.
Have a benelpal mterest in�the entiry thal is�liable�(or the-property;taxes on the property�and that owns_the property or is buying under a wnVaU.
� r,ml.�.�•�.1-cd�ahn��rn�eo�gc�c:h..-f.r.tr.di••^r��.....rn-e^.-��.or•....-.. - , � ,..
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^0 F' �a.9\�:llJ9�,J''.�'nEr,���•.55'!;S"i ...' aa:.^� " . . .
Pa cg/u — r n/� a� e^lsiri�AOJ /"�j �� � I Is ihe Property ip question:
% O O �� �qFi Raal property ��❑ �bile Hwno (I.Q 61J-7)
H any portion of the resWential sWClure w the land not exceed'ng�one�(7) aae�t7iat immeCiatefy�surrounds�thal Gure is used b produce income. desaibe Ne use anC por[ion
ot Ihe properry uWized to produce income.
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Coun1Y -e.�� dfael6.z 7^=r�' 6 a�o: �:^ : c I�T,Ox059 �P:3'J 3:4 2; ^, q!- �g' ( Au•y �
iI hereby cerG(y �he above statements are W e; c'orrecCand'complete"� °
5tmef, city, 5fate,-ZIP
�e of Gaimant
��� ,j:`�'tt,�,�T��x,��,�',�:�;STANDARD:DEDUCTION�auowa►+cE �.
��r °�$u'a,4i�;�� kxi�'>�'�`���-:�a.
20_Pay20_
Le>ser of 1/2 Homestead S
Valuabon a 535.000
Signature af Audila " Date signetl
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