HomeMy WebLinkAboutHomestead_Weisheit�; CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
� State Fortn 5473 (R6 / 403)
Prescribed by Ihe Department ot Local Govemment Finance
INSTRUCTIONS: See revcrsc side lor /iling mstrucfions. �
� � �FORM: "°� � YEAR
�,r5�j f� NC10i� '��
1� —
MAR 1 y 2004
� M'e) iJ �"�..�., �,.... -
. ceRity;that,on�.thellst�8ay of�March; 20
I(We) occupied as our principal place of residence the followin d cnbed real property for which a Homestead Property Tac Credit is hereby daimed:
❑ I(We) owned ❑ Are buying under contract
, Have a benefidal interest in the entity that is liable for the property taxes on ihe property and �hat owns the property or is buying under a contraU.
If buying on conUad, Fee Simple owners name
RecoNefs ofice where conUaq is recortled
r-�-s�`�xy'�..A"�,�'.�=n'. v�.� W'i^.�';- �,��
cTx.€�+=rta`-�`��CS�t'.
Counb _ . Tavnship
��y o33ia-UO ��l �
H any portion of the residential swcture ar tha land not exceeding one (1 � acre
of Ihe properry uUlized m produce income.
�-==*�"�'#,������ � ' �' _�����.� �-=�.�FROP.ERTY;OYVNEO
County Twvnship
I hereby certify the above statements are W e, coved and complete.
Address (number arM sLee4 ci(y, sfate, 2fP code)
Rewrd number � Page
rown,
�IS t�e D�PertY i question:
1(I �Real propefty ❑ MoWe Hwno (/.C. 61./-� .
wrrounds ihat sWGUre is used lo produce income, tlesuihe Ne use antl portlon
claimant
�� ��'`'�'�-'��`��'`���"°`� ��t�`� 5�'•-� � TR EU TAX'-�'+� h ASSESSED;VALUE '} HOMESTEAD � �NON�•,RESIDENTIAL -•[ t?
� � �,A,�SSESSOR USE ONLY�- ��-, � :� }�`' ,y�.. y�UEi""c-,,," � /1T 100°/a'OF'TN � � VALUE ' �",-�4i.,�VALUE ��.''3�
x . �+' : aintsAL'+��.. ',Yy.i ��.`'�..c:y4'€:S3 r.�+..v� _ .� , �,.z`r.... dY �iCK,T .e� x��"�
Land nol exceeding 1(one) acre immediately ����, �� ��Y3"' �'-' „�'„
surrounding resi0en6al improvements. (» �3;c���: iG�c.�,�r���. �
s ,8a
Otherland � �'�`����'�' �
. (2) ��.�"�� #
� ?mr�� _�5�
Tdal land (line 1 plus line 2) �3)
3�`�`?"�?�t:�z"-�"�`z ' == s.,W�
Dwellin9 (C) ?�"L�3t��!.��,:,•: .t-�.�ec�;,
Residen6al improvemenfs ar Mnually ��`4�''������`��-�^`�'
Garage 5 ,. 1 f` � -c,'�,� °
Assessed Modb / ManuFaclured Home � � � �' .. `T�rt;�'c �
�€*E�.:. �•-z�-.;=
Other improvements (g) y iy-v°
�t'�'.Ya�_.
Tdal improvements (line 4 through line 6) (��
Tcfal value (line 3 pl�s line n (g)
I hereby certify Ute above is We, corred, and Signature of Psseswr�i Date signed
complete.
Vrrih�ing action - SignaWre of Puditor Date signed
1
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�^' �*=��r"�.`�.z,za;ia���.i�''i`� ��ST/WDARD;DEDUCTION'ALCOVJANCE,f,''_��wi,:��`.:�`�;�'t-�=��i+;� ��",y',3,�y�`?Yj�`",i�''-.�
20_Pay20_
Lesser of 1/2 Homestead S
Vauauon a S35.OW
Synature otAuditor " Date signed
1