HomeMy WebLinkAboutHomestead_Whitten (5)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STAlVDARD DEDUCTION
Sletn Fam 5473 (R6 / 403)
Preeaibed bY Ne DepmCrant d Local Cwvmmnerrt Finaxe
iNSrnucnoNS: s� �� mdo wr�;�mucm„a
FORM ,�`\� YEAR
\`
HC10 �
��e) w�V / rti that t 7 da f March, 20
I(We) occupied as our prindpal place oi residence lhe following described real property for which a o e�a Pro e T c�' is hereby daimed:
❑ I e owned ❑ Ne b � �
(W ) uying under contracl q�p�
' Have a benefidal interest in the entity thal is liable for ihe property taxes on the properry and that owns �p}o{iert� otFiWBying under a wnVac[.
I( buy'ug on conirad, Fee Simpe owners
Remrdels olfite whera coniraU is recorded
Tamship
Pazcelpqnlyr� � .�/' ��� I Legal deuripti0n
v� �
tl any portion af the resiEenlial sWcWre w the land nd mcceedi
ol the property uUl¢ed tn produce income.
County
Tavnship
Tating
Is the
(7) acre t�at immediatety wrrounds
I hereby certi(y the above statements are We, wved and complele.
sVeet city, sfate, ZlPcode)
County
GIBSON
Record number
Page
�v,ocem O r,,ocna Ha„u ci.c. s,.,-n
is used lo praduce income, Aes(xibe the use and poNOn
���
�-�$\
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° �'� �u�'''-"��"��`` w'�� ���'��'—� � TR EU TAX�a ��ASSESSED VALUE �AHOMESTEAD �` 3,`�' '" -NON�<,REStDENTIAL��
�i�k.� 'spS5ES5OR�USE ONLY` 5a
0
��..�is;� � �:.^_:�°rv'.zY#Y$-�;"3F��.�°A.T'.1�. �s..%� �VfU:UE��s�i AT�700%e:OF�TTV� �.�VALUEI��� i--�^��.Q�z.`�.'#EB�VALUE� :.`e;`��
Land not exceeding 1(one) aae immediatety �;�'�` .,�-K �"�,,-�°�„�';'�'�.� ��
surroundin residential im rovements. (� � � a�'"�"' '� fi-. s ''
9 D t �."� `� . ���'f'.
Otherland (y� Y.-�K-',-�"�.-0�,' a}������ M
'✓�'+Ya���=_.S `v_3_
Total land (line 1 plus line 2) (g�
� ��a�1��`�����:�w
Dwelling (4)
�ResidentiallmprovementswMnuaOy �."..49Y'�. `"'�'�°•.�"£-
A� Mo60e / �Aanufa�red Flmie Garege (5) i�a� ���.s .�o'§a'���
'� '*'�a�: .�
Other impmvements (6) �'-�# ���;�-��
�� ;� Y
Total improvements (line 4 through line 6) ���
Tdal vatue (line 3 phs line n (g�
I hereby certi(y ihe above is We, corred, and signamre otwssessor Date signed
mmplete.
Verilying act"nm - Signature af /Wditnr Date signed