Homestead_Wright (14)?A rt��° CLAIM FOR HOMESTEAD PROPERTY TAX
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`'�'-'� � CREDIT/STANDARD DEDUCTION
` , State Fwm 5473 (RS / 10-07)
���� Prescribed by �he Department of Local Govemment Finance '
INSTRUCTIONS: See reverse side Ior /iling inswctions.
p� FORM
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SY�R—�
I(We) � p1 K.- l� �Y � l/ prK.�� �C/ �����l� certify that on Ihe 1st day of March, 20_
1(VJe) occupied as our principal place of residence the following descnbed real property (or which a Homestead Property Tac Credit is hereby Gaimed:
❑ I(We) owned ❑ Are buying under contract
, Have a benefidal interest in the entity ihat is liable tor the property taxes on the property and that owns the pmperty or is buying under a contract.
���.'.:�`.Yyc:�sr#'.;,'!. "'<'-.�:?.;4�r-<-aFS�= ...:�...i:Ss"'=:CONTRACT�RECORDED",,:" ..i'..�..-; r�� �:a3 " '
I( buyug om m�traa, Fee Simple owners name
Reco�defs ofice whera contract is recorded Rewrd number Page
County
Tamship
Tmcing tlislrict (city, fowq fownship)
_ _, � _.� t;:
Parcel number Legal descnption Is the property in 9uestion:
fl / 9- Q p�g S' Ud ❑ Real property ❑ Mobiie Mwno (LC. 6f.1-I)
6f-E
If any portion ot the residential sWCture w the land not ezceetling one (1) acre that immediatety surrounds Nat sWCture is usetl b D��uce income, desvibe the use antl portion
ot the property utilized W produce inwme.
>`�� �"�`��r�.,,Sx.,.;.i,tu�)-i;�Y-.' -��'.�.-.'?_�PROPERTY.OWNEU'�BYCL'AIMANT�INOTHER`COUNTIES+,,, X-��-:':`<'r �a'� "1�S':;° `"�=�
_�
County Tonnship Caunty Tavnship
I hereby certify lhe above 5tatements are W e, CArrect and tomplete. Signawre of claimant
Address (num6er and sbeef, ciry, s(afe, ZIP code)
'�sz. t'�k�'+'y� -��' � "'�� -'�"}}-� � �-� ��"TRUETAX , ASSESSEDVALUE HOMESTEAD � �� s3 NONRESIDENTIAL ����
�„z�Q��A5nES5OR�UsSEONLY�� re,;�y.N,� .VALUE� ,j."AT-t00YoOFtT�N ';�.�VALUE��.��3F`�r� , `?VAI.UEh,�„��k�$
Land not exceeding 1 (one) acre immediately �._ } �� f" {�� "c . � �-� ��: ti
surroundin residential im rovements. (� � - _;rr ::,.=,`�� � tr �
9 P - : ,t :7.tae;•;, ,-E_• �.
Jc , wj!'+k Y ^`-',' Y
Other land (p) ,, �1�:;: �-��_ � -
Tatal land (line 1 plus line 2) �3) �
..;o- . i �e r f�, �X�y`�n�r �'.
Dwelling (4) _� �4 �#'�?"n�e�.'3- �';is.:�.
Residentialimprwements "��5y ..'rht �,��,_
Garage (5) �;� -4;�'•�,k�` �i�7� i..,'''`
J�z.s"S:.'rv'^-'r::'._�r,:�-.,. bf`.::��=
y'� �.: .i �-'�-.fi .
Other improvemenis (6) '
�j ��'-�
Tatal improvements (line 4lhrough line 6) (7)
Tclal value (line 3 plus line n (g)
I hereby ceAify ihe above is W e, conecl, and Signawre o( �ssessor Date signed
complete.
Veritying aclion - Signature oflwditor Date sgned
�'��. , ?�+ �•�,`_�-.::,;aT�'-�."� ..`+: "'��`�:_'••��:.STANDARD:DEDUCTION�ALLOWANCE .:r.. >'.�,`a,Sa f. -.«�..--" :�. ='N�'_�-''_'v `,7;�?ti;7,<-�. � -
�� :�
20_Pay20_
Lesser of tf2 Homestead
Valuatlon or 56,000 S
Signaluro al Auditor Date signed