HomeMy WebLinkAboutHomestead_Young (12)"'" CLAIM FOR HOMESTEAD PROPERTY TAX
�.._ s STANDARD / SUPPLEMENTAL DEDUCTION
State Fortn 5473 (R72 / 6-09)
�� 2 Presuibed by [he Departmenl of Locai Gavemment Ffance
INSTRUCTfONS: See 2verse side !or �iling insfrucGOns.
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JUL 3 0 2009
I(We) certiry ihat 1(w�j" ur) pnndpal
place o resid or am (are) buying the follow described rea roperty for which a Homestead Properly Tax Standardp cliort i� �+im�d
under ct on lhe date Ihis applica�on is (led, � (date oI filing): GIBSON G N� T S
I(We) own ❑ Am (are) buying under recorded wntract
❑ Am (are) entitled to occupy as a lenant-stockholder o( a cooperative housing corporation
❑ Have a benefidal interest in �he Wst or lhe nght to occupy the pmperty under the tertns of a qualified personal residence Wst
spouse (legal name)
(last frve
It buying om m�tract, Fee Simple rnmeYS name
RecoNers offirc where convact
Counry
Township
Drivefs (cens� Idenlifiration / Olher m�mber
ol Uaimam (las( �rve d"gits)
DmreYS ticense / ItlentiYatian /
rown, fownshiv)
Is ihe pmperry in queslion:
Record number
Page
I' �.. � V��� 3 u� `• �� 1.�.�V U I U Real P�PenY LI AnnwM essessed rtnbile home GC &1. f-71
�If any portion ot Ne residential swcWie or Ne IaM noc exceeding a�e (1) aue �h/at immed'utey wrtounds ^�hat atrucWre is useE m produca inmrne, Eesuibe the use and portion
of Ne P�PenY uoT¢ed co P�ure i�ome. �� I 1�\AI 5 N�.Q�
ti� ��
Counry
Township
I heieby certify ihe above statements are we, corteu and complete.
ss (n�mber aM streel, ciry, state, and LP cod
G iN o --f
..• .
Land not ezceeding 1(one) acre immetliately
Otherlantl
Total land (line 1 plus line 2�
Rrsidentlal improvements or Mnually �����9
Assessed Mohile 1 Manufacturetl Hane Garage
Other improvements
Tofal ImDrovemen� (line d throug� Ilne 6j
Total value (line J plts line 7�
I hereby certify the above is [rue, correct,
and complete.
Vai/yi�g action - Signawre of fu�dlw
u
(�)
�2)
(3)
(4)
(5)
(6)
(B)
Sigriatura ofASSessor
Counry
20 _ pay 20 _ Lesser of 60% ot the assessed value of Ihe homestead or $45,000
Nohui(hslaMing any otherprovision, the sum of the deductons provided in IC fr7.7-7P to a mob�e Irome Nat i5
rat assessed as real property or lo a menutectured home fhet is rot assessed as real properry may rrot erceed
.,�o.n�x i�rn n� mn wcm_ccerl value o1 the moGi/e �ome w m2nufactumd home.
3
Tovmsftip
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signetl (month. daY Yea�)
Date signed (momh, tlay, yea�
Sq7naWre of Puditw I Date signed (monN, day,
A,