Homestead_Wilson (10)CLAIM FOR HOMESTEAD PROPERTY TAX
_ CREDITISTANDARD DEDUCT�ON
Stete Fum 5473 (R6 / 4-03)
PresaiEed hy Ne DepaRment of Local Govemment Financa
INS7RUCTIONS: See /everse side /or filirg insbuctions.
FORM YEAR
H 7'0 �
0
/1 / fY t' t �`�'� 'KA �� 20
��e) ,J�J � .�� / � certi lhat on th 1s a f ar
I(We) occupied as our principal place of residence lhe following described real property (or which a Homestead Pro�"ef�9'�i�j�rerebyg�i�Rd:
i� I(We) owned ❑ Are buying under wotract
, Have a benefidal interest in Ihe enGry that is liable (or ihe property taxes on the property and that owns the property or is buying under a contraU.
11 buy'u�g on contract, Fee Simple ownefs name
Recordels affice where conVacl is recorded
6J�Y-C.CJ /�/ ��
If any poNOn of Ne residenllal sWCture w
of tha property util¢etl to produce income.
County
To.vnship
Tavnship
I hereby certi(y lhe above siatements are true, cortect and complete.
Adtlrass (numberaiMsbeet, cify; sfate, ZlPCOde)
�n
Nat
town,
Is the
Record number � Pa9e
�/ I �Real properry ❑ Mobile HOmo (I.C. 67.1-�
surrounds tha sWCture is used to Oroduce income, tlescribe the usa and portbn
County
�-� lo ^7 �
��� �a�ASS�E35OR 11SE ONLY � -�� � � �y�TRUE,T'AX� ASSESSED�VACUE � HOMESTEAD'� � NON?RESIDENTIAL�'�??
��,a.�Lv _ s ra .:,r,� _ �-?�.���� `'�.cVALUE�..�".:•. AT100/a.OFMTTV� s�FCr_�<VALUE�� ������'1's.V-'4LUE�'�`����.vid�`v'_'t
Land not exceeding t(one) acre immedialery j° y�;�""�. °C �"',.���
i+
surrounding residential improvements. (�� ����� �������,�-�
Ofher land �Z) �����'.,:,'�t� ��'�'� -
. e�'-e�'�iY�S�
Tdal land (line 7 plus line 2) �3)
.: �,�.,. z�.;�,{�.: ���y� sti :��s
Dwelling (4) �:r.. >'a+���'-.Y{.`,`.�4,'-iC.?�'t'"'# '-�
�=��:�"�...x:.:_�'',-�;��c'
�ResidentlalimpmvemenLSOrMnuaqy �"^�"^` 'S'�'-'� �
P�ssessed Mahile / ManufacNred Hame Gara e ����f,�s '� �
9 (5) ��"�k�r.�.R��a. r .�"
� ti�.�i
Olherimpravemenis (6) �+A�"" '-
}-+. �����'
Total improvemenis (line 4 fhrough line 6) ��)
Tt3ai value (line 3 plia line n (g)
1 hefeby Gerti(y the above is We, coned, and SignaWre of Asseswr Data signed
complele.
Verifying action - Signatura oflwdimr Date sgned
..._,'"4�_.. �-.���;�,�,F-�`'.rti�i�''ir°�.�,��,�3.'�'-ST/WDARD:OEDUCTION'ALLOWANCE -,"..-` °_-,. . 4 ...:a,
'� �j"� � ' ._ . . � _ �:;hr�..s'�'1�""'�'.��.�i-�-"�'��A�.��''���'Y�
20 _ Pay 20 _
Lc;ser of t/2 Homestead
vauanon w E35.OW
5
Sgnalure of Auditor " Date signed