Homestead_Woods (12)CLAIM FOR HOMESTEAD PROPERTY TAX
� _ STANDARD / SUPPLEMENTAL DEDUCTION
51ate Fortn 5973 (R73 / 12-09)
� PresaiEed Dy the DepaAmaM of Local Gwemment Finance
4N
INSTRUCTfONS: See reverse slde (or filing insGuUions.
FORM
HC10
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v
�(We) certih' that I(we)I���ip'��d.�s rt�' �Qur) pnn°Pa�
place of residence a am are) buyirg the fdlowing desaibed real property fw which a Homesiead Properry Tax Siandard Deduction is hereby daimed
�er contraG on ihe date Nis application is filed, (date o� filing). I(We): C���
Own ❑!vn (are) buyirg under recorded conVact GIBSON C�
� Am (are) entllled to occupy as a tenant-stockholder of a cooperetive housing corporatlon OUNTY qUDITOR
❑ Have a beneficial interest in ihe Wsl or the right to ocwpy the property under �he tertns of e qualified personal residence Wsl .
❑ Am (are) the shareholder, partner or member of Ne entlty that owns ihe property.
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R'iSY R'_ ? �♦ - �n 42 v.��:..t.S'%.S
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/ ONet
of tlaimanl (lest five dig2s)
d'glLS) Drivers ticerae / Identlfiration / Otfx
of daimanYS spouse (Wst frve dlpi7s)
tlawiptlon
If am/ porlion o( tlle residentlal shutture or fhe Imid not eueeding ace (1) atre
Wlhe ptoparty u0f¢ed to protluce income.
•
7ownship
I hereby cerUfy Ne ebove sta[emenis are We, cortect and complete.
Address (n� er eM straet, pry, uate, ana
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i iF.c.{%..
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Land not azceeding 1(orre) acre imme
surrounding residential Improvements
Other land
rotal land (lina 1 plus qrre Z) .
ResideMlal Improvements or Mnually
Assessed MobOe I ManuFacWred Home
Other impravements
Dwelling
Garage
Total improvemerrts �line 1 tl�rouBh line �
7ota1 vaWe (line 3 plts flrre �
I hereby certlfy tha above is We, coriect,
and eomplete.
Verify'ttg adbn - SigraNre M AudiWr
s �
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(2)
(3)
(4)
(5)
(6)
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Tabrg
County
issuug
Remrd numbas � Page
Is perry in Question:
I popelty � Annually assessed mob0e home (/C 67.1-7)
untls ihat sbumre is used to produce imm�e, tlesrnbe the use and portion
20 _ pay 20 _ Lesser of 60% of the essessed value of the homestead or $45,000
NoMithstaMLg anyWAei povisbn, fhe s�m o/Ne tleductions yowMed in IC &1.7-12 fo e nmW7e homa that is $
not essessad as 2a1 poperty w fo e man�Eecfured home Nat k not essessed es 2a1 property may nof exceeE
nm.hnn /f/ll olthe o�+.«..�f vel�re o/ fha rtqbde home wmen�deUUred home.
7ownsNp
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�am sig�rea (monm, asy,
Date