HomeMy WebLinkAboutHomestead_Whisenant, ryn t CLAIM FOR HOMESTEAD PROPERTY TAX
- �" • CREDIT/STANDARD DEDUCTION
�,•. J State Form 5473 (RS / 70-07)
Prescribed by Ue Department of Lacal Govemmeni Finance
INSTRUCTIONS: See reverse side (or filing instructions. J/
FORM ^Nn YEAR
HC10 I �
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I(We) certi(y lhat on hCe p1 st day of Marc�_
I(We) occupied as our principal pl f residence the (ollowing described real property or which a Homestead Properl�iak7C�c�j is��y Gaimed:
❑ I(We) owned ❑ Ne buying under coniract !
�ave a benefidal interest in the enliry that is liable for the property taxes on the pmperry and that owns th o" uying'Under a�nV�c .
�orn. �!�'
ts�rv7 ,UD170R �
r;.-�'@� _� ..:Y�_'{'-'fc'� 3'"t.�.`v`�`.at��'`.���'_.::� Si.. s:���v'r'� �<CONTRACT'.RECORDED �f="'�-r� x+ eEr .��rt, 3� s sS� ° =e.-:_• '
.� . .�: :
- . _ rc .�z7 _,:�. � , 1 �._. w4.. -j} _.� �.
If buying on contraq, Fee Simplo ownefs name
Recorders olfice where wnVad is recorded Record number Page
County
Tawnship
CA(�J ' �J
If any portion ol the residentlal sWclura w the Wnd not excee ing one () acre that
ot the properry utilized to produce inwme.
I herebY ce�fy� 3 ve�atempnts are
�
�ddress (num6erand sVee ity, sfate, ZIPCo
� sl �ct (ciry, fow�township)
� Is Ue property in queslion:
❑ Real pmparty � 67obile Homo (/.Q 67.f-7)
sunounds Ihat swcture is used to produce income, desuihe ihe use antl portion
County
G'S�) �71�
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�=���'4�����'�-•f'� �'�:4 i w�:� TRUE TAX � ii ASSESSED VALUE HOMESTEAD ��',�.� NON-RESIDENTIAL" "+' �- r�
���'Tc� �3'A�Y�� �S.��N.. nY.�.� :��'RS,.$� `�r"-�'vVAL:UE�;:.�....� �_AT t00Ye'OFTN,u' ar.i:^.VALUE!"p�" �*°��.��.,:;aVAl:UE3..:b ��%
Land not exceeding 1(one) acre immediately ;" ���"'"��F�°�i : �'� �` r
surtounding residentlal improvements. �� � ��'` y."`��.>.� �; `.�- -=P' '��'�,'t :�.
-��' ww:'`, 5� '
Other land (z) �?��" �e�, �
� ;.t :±�x _v� .iA+..: _.�--.
TUaI land (line 7 plus line 2) �3)
Dwelling (4) �-� ��. �,1'.�� -�`'� n� uµ �n
�
Residen6al improvemenls =3 "'�'`#'#��"�€`�''°"',r s �r` 3''��'
� 3�� �<
Gara9e (5) '��.r ���'� c ,°"�+�+��_:
2 ;�.�� � �.:;a!
Otherimprovements (6) ��;:��� �
' .:=t<s.°i.as.«,„.�i'%
Tolal improvements (Irne 4 through line 6) �7)
TUaI value (line 3plus line n (g�
I hereby certify Ihe above is We, cortecl, and Signamre ofAsseswr Date signed
complete.
Verifying actbn - SignaWre ofAutlitor Date sgned
i��*�it'i..��sv.�a+�.T�"'�.�'" e�T'�.�..-,Y.�?'.`�'.,ie.�o i��'.�57''"fi'r--STANDARU:DEDUCTION�'ALI:OWANCE.a�.l3's:��v�s.o-+�^.t`u"�-,�xx ��','� � �ei�s��5.��� `�aY. �. °_
20 _ Pay 20 _
Lesser of 112 Homestead
Valuation or $6.000 S
SgnaWreoflwCilw Date signed