HomeMy WebLinkAboutHomestead_White (13)CLAIM FOR HOMESTEAD PROPERTY TAX �oRM ' YeaR
t CREDIT/STANDARD DEDUCTION HCto
S�a�e Fwm 5473 (RB / 4-03) � ��
PreSCribed by the Departmem of Local Govemment Finance �� � _q II ��
INSTRUCTIONS: See reverso side Ior 61ing insfnic(ions. ��' �L—J +�
��":��a'T��'�""�""""`fr'`'�` !''�` ��'�""`��K"CERTiF.ICA ON�STATEME � � �
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�. _ m.�,, rA'.�'�... ��L`+�.�' _'r� '�x�,✓"��..STi�s:.,�._y,��'`a��wi�:.`�L�� s..�'-=`
��e) � certi(y ihat on the tst day o( March, 20/i %/
I�upied as our principal place of residence the following described real property for which a Homestead Property T�c CrediUs hereby daimed� �
tti..�.�-�f�.. ' _
I(We) owned ❑ Fve buying under contract .� C.:�SG�� C� -
� Have a benefidal interest in Ne endty that is liable for the property taxes on the property and tliat owns the property or is buying under a wnVaU.
It buying on conUaG. Fee Simple owners name
Remrders ofiice where conVaa is remraed
t��,�`���7k���:�e�"�°�..t3.'n�'�v�?�� i
County � Tnvnship
fownship)
Recard number � Page
Narcel numDer L descrip'on Is the pmperty in question:
�� - G'y/ 5� - Q� Q� �/ �Ofjp �7 ❑/(� p�o�mi ❑ Mobile Homo (1 C 6/ 1-�
N any portion ol the resiEentlal sWqure w ihe IanA nd exceeding one (1) aae that immediatety surrounds that s ure is usetl to produce income. descnbe Ihe use and ponion
af tha properry ulilized tn praduce incoma.
� �"i�-°5- �a-3- � � . �5a _oa �
� � ��:Y`����°,:-. �,� • ��-a..�. �,.. ._ �: �-� ,t
�' ���"' � 3. TRUEsTAX � �ASSESSED�VALUE �- HOMESTEADi eNON-RESIDENTIAL
"' ��ASSESSOR�USEONLY ' d'a- ` }^ �T�
�-P._ ;� .G4�Yh°`��:C�e���'�-�V�.����� �ALl1E-��� wALl700%'OF�TTV� �,r.�.VALUE+�z'�'3.� C��>�d.-f-.�';::.VALUE_ �::��
Land not exceeding 1(one) aae immediately �_ ��. �,�"z� "'�'��,,.��,a�s��
surroundingresidentialimprovemenis. (�� �-�"'`�'�,yy�s"��.��'i�u���
Other land (y) ."�� �� �
. �.su.a„ �-,�".�--4-_:i?�
Tdal land (line i plus line 2) (g�
�'..�rv �l�-.So.-3-�'/GA � fi ���
Dwelling �4) � "^�'� � d r ��'�`-�'.:�� i�
Residential Improvements w Mnuatly ��° �"����rr�����.tlif
Asse�ed Mohib / Manufec9�rad Home Garage (5) ,�ti,�� �� `-�"�'��
���:�,.,:������x ��;
>� �:
Other improvements (6) � .�; �� }
2 F ,��. J!• .
s -�s
Tdat improvements (line 4 fhrough line 6) (7�
Total value (line 3 plts line n (g�
I hereby certi(y ihe above is W e, coved, and Signature otASSesmr Date sgned
complete.
Veri(ying aclion - Sigruture oflwdimr Date sgnetl
'; -�+�.`';�'�� "F'�.�.i? �" - �;�."��?'x'.�c',t>�s�.`�STANDARU:DEDUCTION AL[OWANCEi'�`��i.�cl,f`'rt %�,i�'.?Px�-�To�zt�t..7"����i..,.`�#'•�.,xi�r:�+'Fi_=.'-
20 _ Pay 20 _
Lesser of 1l2 Homestead
vaivauon w 535.000
$
Sgnature oflwddw - Date signed