HomeMy WebLinkAboutHomestead_Wilkerson (13)` CLAIM�FOR HOMESTEAD FROPERTY TAX
� CREDIT/STANDARD DEDUCTION
t / State Fortn 5673 (R614-03)
' Prescribed by tha Departrnent o( Local Govemment Finance
INSTRUCTIONSi See reverse side �or �ling instnm.tions.
-- - ---- �� YEAR
FORM �
HC10
�('�'e) ��,Ld�1„/�.[_���� certify that e{%{g t y of 2
I(VJe) ied as ur prindpal place of residence tha fdlowing described real property for whfch e Homestead Pro TmtlG�� n�e
I(We) owned ❑ Ne buying under contract ^A q ,nn�
Have a benefidal interest in the en6ry Nat is lieble for the pmperry taxes on the property and Nat owns the property or is'U�ngVn�er�e�tlb�Vacl.
If buyinp on contrep, Fae Simple ovmefs nama
contrea Is recpded
CouMy
I( arry portim M Na residentlal sW cture w the
ot the properry uWhad to produca inwme.
not ezceeding one (1) acre
I hereby certify the above stetements are We, correct end complete.
Lend not exceeding 1(one) acre immediatey
surtounding residentlal imo�ovements.
Otherland
Tctal land (Iine 1 dus line 2)
Dwelling
Residential improvements or Mnuairy
0.ssessad Mobile / Manufactured Home
Garege
Tatal Improvements (lina 4 through lirre 6)
Taal value (line 3 phs line �
I hereby certify the above is we, corteM, and
completa.
(�)
iz)
(3)
(4)
(5)
(6)
��)
(8)
SipnaWre ofAssassor
Record number
distriC (ciry, town, fownship)
PeBe
_ ( Is ihe property in " .
Real pmPerty ❑ Moblla Homa (I.C. 67.7-�
surmunds Ihat sWCtura is used to produce incoma, descnbe Ne use and portion
Counry
+' .. ::;,
Data
sipned
�p r -.,-�* s °` YEid, �E" t `,7_ . .. . �:,-.fk v ..�e'• v -„t {.; f.:..;_..,.. .
���i�'''�'�+,�.a����-�'��`_'<-�...� E'?'�:r,'ti3STANDA,RD'�DEDUCTION'ALLOWANCE�� ...e.••..a . ..:��n.� E*,��, ,>.. ,�.»..��'�:�_
20 _ Pay 20 _
Lesser of 1!2 Homestead
Valuauon or 535,000 S
SlpnaNre af Puditor Date signe0
. . _ _..__________ ........................................................'_......_...._...'..'....................'......._...................................__....._........_......................................................_...'.