HomeMy WebLinkAboutHomestead_Webb' CLAIM FOR HOMESTEAD FROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R614-03)
' Prasaibed by Ihe Department of Local Govemment Finanu
INSTRUCTIONS: See reverse side for filing instrucfions.
FORM
HC10
YEAR
I M'e) T� C,�(.twc.. �+ V`�� / 1 Lw Sl�L�V[T ceNry tha��1�''e 1side•j��Merch. 20
I(VJe) occupied es our prinapal place of residence Ihe tollowing described real property for which a Homestead Property T�c CredTis Ft4reby Gaimed:
� I(We) owned ❑ Ne buying under controct
., Have a benefidal interest in the entiry thai is liable for Ne property taxes on the properry and lhat owns
tl byMe on convaa Fea s4npe owners name
RecwEeh oRca where conuact is recorded
Counry
If any
d Ne
Tamship
L IdescripGOn
iOenUal sWCture w Ihe land
to produce income.
number
Tmcing disVict (ciry, town,
a convact. �
PaBa
�^� I Is the proparty In quesUOn:
( Z ❑ Real pmperty ❑ Mobile Home Q.Q &1J-n
ona (7 � aae Nal immediatey surtounES Nat sWCture is usad to prvduce Inwme, desaibe Ne usa and Dortion
c
�ouncy To.vns�ip CouMy
I hereby cerfify Ne above stetemenLS are We, cortect and complete. Signature oi
mss (numDer and sUee4 ciry, stata, ZIP ooda)
{�x�y`',.����flL `�'����'��T'�' �� �r�"y �" �TRUE�TAXsx �� ASSESSED,VALUE � HOMESTEAD �"n i°NON�RESIDENTIAL�sqV
n„ry� AS9ESSOR��US �ONLY�s��; ��Yt`i -' ft 4 VALUE'�.,�,*_ •�AT-100X OF:TN4 s-=-�: VALUE r��: .� ,_ z_....cVALUE i� y.
-. ...,tz .. _ , .. .,.__,. r �*-.+,.,,�.n� . :.� ; . . . .. . ... , . . .,: . :. �. ;�.
Land not exceeding 1(one) ecre immediately _ v -
surrounding residentlal improvements. (�) _•'�, � s -;�_ _ .
Other land �Z� - _ - _
Tatal lend (I/ne ! plus line 2) �g�
,
Residen6alim rovementsorAnnuai �'''�elling (4) "" _ :.� '� �--�{ �-
P N ;-t:�_:....v.-�„',n:>* -:��r' _
Assessed Mobile / ManufacNred Hwne - :r_ , <<„ 1.
Ga2ge �5) _ -
;;�1 ..e..._ .
t z.;
.O�pe1(mprovemenis � (6) . . . . " .
TUaI Improvements (Gne 4 through liire 6) ��
T�al value (line 3 plrs line n (g�
I hereby ceRi(y �he abova is We, cortect, end Signature olASSessor Data siB�ed
completa.
Verilylnp adbn - SipnaNre otPuditor Date signed
I. , .,:"9``.�1' �!{.s'.t'r':Fi�r .-.�>;us=A}��t--_c..e: _ .�ezi_:..'.STANDARD'DEDUCTION'AELOWANCE i ' = ' - -_ .
' � 20 _ Pay 20 _
lesser of 12 Homestead g .
ValueGon w $35,000
SlpneWre of Auditor Data N
t3 .�`d-/D -r�