Homestead_Wirth (5)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Siete Form 5473 (R6 / 4-03)
Presaihed hy Ne Departrnent of Local Govemment Finance
INSiRUCTIONS: See reverse side /or filirg instnicfions.
FORM � YEAR
� �" c�a "
MAY 8 2006
�(We) �C_Y//�nLnm� L-C/dBJd i�r�..,...� —
� certify that on Ih�! 1st ay o( March, 20
I(We) occupied as our principal place of residence the following described real property for which a Homes@��S�fYaie&1.f�4tT6A€by daimed:
�I (We) owned ❑ Are buying under wn�ract
, Have a benefidal interest in the entity that is liable for the property taxes on the property and Ihat owns the property or is buying under a wnUact.
If buying om m�trap, Fee Simple owners name
RecoMefs ot�ce where conVad is recordeA
County
Tamship
Tating tl�lri�(�'ty, tawn, townshiP)
Rewrd number � Page
PaScel number p L I descriptlon Is the pmperty in question:
�� �'(Ja 7�7' �) ���E ❑ Real property ❑ Mobile Homo V.0 b1.1-7)
i( any portion of Ihe residen0al aWCture w Ne land nat ezceetling ona O aae that immediatety sunounds Ihat shuGUre is usad to produce income, desuibe the use and poNon
of the property utilized tn praduce inWme.
- . ..-.� �. �.
� � � �AS�S sES�50 RU �ON Y- ��'-'��`'��� �,FVAI:UE""�� � AAT.100%OFl7V �WH�VALUEDK �NON VALUE�T�L �
c.:�1 -2��E.:�-}•c� z-s��. ,,..fi&;,� ti �-,�3.� s �'T ...u.,..-�� �ari��., .,cx.,..� �
Land not exceeding 1(one) acre immediately y�'��- z` � 3�}� 3�
suvounding residential improvements. (� � �_ ��?��'���� � t �'�;
;- .
Otherland �2� `�������'y �
�--�n� :�:s"�..a_-: �v�:`a
T�al land (line 7 plus line 2) (3)
'tx: '»sk .�i�.�.`'�
Dwelling (4) i '��-��� . �_f ���,�
Residential improvements or Mnually f� �
Pssessed Mobile / ManWactured Harre Gara e ��"< 9,. 't'$'��`
g (5) ,��,,.�-� >
"'�'-,`�,'F.+ ' � � `�� �:: w... _
�i=�}���.' r7�s'
Other improvemenls (6) ��`�"`',�;��
'-,.� 6'�a. i.�
Tdal improvements (line 4 fhrough line 6) (��
TUaI va�ue (line 3 pl�s line n (g�
I hereby certify �he above is We, corted, and Signature of Asseuor Date signetl
complele.
Verifying action - Signature of Autlimr Date sgnetl
20_Pay20_
Lesser of t/2 Homestead
vawauon w E35.000 5
ol Auaitor