Homestead_Wagner�rt��v
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
SUte Fwm Sa73 (RS / 10-01)
Prescribed by Ihe Departmenl o( Local Govemment Finance
INSTRUCTIONS: See �everse srde (or filing instructions.
FORM � YEAR �
H�,o p3� :
Tavnship
D/�'i —oe5 /� �s I L�J.d�c.GtuY?,�.
If any portion ol lhe resitlential s4ucture w the land not exceeding one (1 � ave
ot the properry uUlized to produce inwme.
Toxnship
I hereby certify the above statements are tme, wrrect and complete.
(num6erand
;C�^r.''.C-.. a:r..,�
Taaing Aisiritt (cify,
' �� Is ihe pmperty in question:
I�QI ❑ RealDroOerty ❑ blohileHOmo�1.C.67.1�7)
�ly surtounds �hal sWCNre is used lo produce income. desui6e Ihe use and portion
i"»K����'i�'"'`''3�`-`t`` -'� -ii.� � t '`TRUETAX i �� � �ASSESSEDVALUE �HOMIESTEAD� ' r � NON�RESIDENTIAL`� ��-���
��_Ff�,Y�AS�S50 �S�ONLY ���� � .; ..t. ; j+._ VALUE_ �,�_ .AT.100%OF_TN� � i._ :VALIJES � �f � i����,� ,VAI.U�_„�;�!'�2,-s�-.'�,�
Land not exceeding 1(one) acre immediatety p` �,�JJ �'?�t y' �*�'r'�s' �"_-
surtounding residential improvements. (�) ;; x, +�,:�o�'`,s '"-,, i��::��
����4 � ��
Other land (p) � '�";,, s � � �
'.f-��: '�.':��s�.
Tdal land (line 7 plus line 2) (3)
Dwellin9 (4) ��s+r 1 �J' ai� ,-�;���u i'
Residenlialimprovements � �����'� ��`���
r?�.+�t �� ��;-�.�'�-' ._c r�rs- iyfi��'y-
Garage (5) -,r� i4?"3'r�'=••f$' +,`"r `4 ���.'
. T'. nz--r'?r�4 . ��� %" i L. .c.
Other improvemenls (6) .sy y �� � '
-"�:'3.?�' ,.
Total improvements (line 4 through line 6) (7�
Taal value (line 3 plis line n (8)
I hereby certify Ihe above is We, correct, and Sgnawre o( Asseswr Da�e signed
complete.
Veritying aclion - Signature oflwdiror Dale syned
20_Pay20_ I
Lesserof 1/2 Homestead
Vatuation or 56,000 5
Auditor