HomeMy WebLinkAboutHomestead_Walker (14)R� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (RB / 4-03)
Prescribed by the Department ot Local Govemment Finance
MSTRUCTIONS: See reveise side lor /iling insfmctions.
FORM
HC10
YEAR
:
�•'
— i
1(we) (-/L�/l U/Y/ %7, ( 1(9 L%��L/�_I terti(y thal oOt�15(]d� ,yerch 2p_
� yy�
I(We) occupied as our principal place of residence lhe following descnbed real property (or which a Homestead Property T�c Credit is ere"by daimed:
❑ I(We) owned ❑ Are buying under contract � ��% �
, Have a benefidal interest in the entiTy that is liable tor the property taxes on the property and that owns t rt¢ r� �NpE� �nder ct.
I( buying on coniract, Fee Simple ownefs name
Recoidefs afice whare conVacl is recorded
!��,..'��`'c.�t���c.�.a:c�p,��i-r:c
�
County Tawnship
n i�sox.._
1 the residential struqura w the land not exceeAing one (1) acre tAat
utif¢ed to produce income.
County
I hereby certify the above statements are We, corted and complete.
sUeet, ciry; atafe, ZlPcade)
f�N, rown.
�s �a
surtounds ihat
County
SignaWre of claimant
Record number � Page
Real property ❑ Mobile Homo (I.C. 61.7-n
ire is used W produce income, describe the use antl ponion
�
'�� -�A�`�"��'��`"�"��` � �, +..'�'TRUETAX ASSESSEDVALUE �eHOMESTEAD�, � NON-RESIDENTUIL
� ASSESSOR USE ONLY � � �t
;�.�._ .„.�T=�",.,xf,`.��y-�:i'.�i�w,�y,�-.. ���..l4��'.+VAL.UE��y�; AT�700%TOF�3.'TN�'+�.�VALUE4lF`.� _,�..-'�`s•«'L'5.���,.VALUE�^���
r
Land not exceeding 1(one) acre immediately ,;�.�� 3'�.�-�� *' � 'g,7"
surroundingresidentialimprovemenfs. (�) ,-;��_'�'1tz�,�;�;r�..,��:
Other land (Z) �s��.: � '�¢��
r-±.52e.'� +
Tdal land (line 7 plus line 2) (3�
- sr1"` ':Y"^=5�'.F^ �
Dwellin ) '�� � `�'����"f
9 (4 �u`i -�L'=,.:� : �� c � °_'�i
Residential improvemenLS orMnualty ;`'��"�� �'�
0.ssessad Mohib / ManuFetA�red Hane Garage 5 �� '�v`�
� 1 � �.a. � �.-�:
��si�:'. �3::
Other improvements �6) �z�'�'�J. � `
�.+`=� 1.� e�;�y
Tdal improvemenls (line 4 fhrough line 6) (�)
Tctal value (line 3 plts line � (g)
I hereby ceAify the above is We, coved, and Signature otASSessor Date sgned
complete.
Verifyifg aqion - Signature otAuditor Date signed
20 _ Pay 20 _
Lesser N 1/2 Homestead
vauanon a f35.000
S
Signature of Auditw " � Date signetl