HomeMy WebLinkAboutHomestead_Young (11)f CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
� � Siate Form 5473 (R6l M3)
Prescn6ed by the Department of Lacal Govemment Finance
INSTRUCTIONS: See revcrse sidc /o� /ilinq ins6ucfinns. �
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FORM YEAR
HC10
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certi(y that on Ihe 15��( �af�h2��
e of idence the tollowing d scr ed real propeAy f r hich a Homestead Property T�c Credit is hereby daimed:
ying under wntract y�l� ��
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entity Nal is liable for the prop taxes on ihe property and that owns ihe property or is bu 'ng er a c ract.
GIBSO�J COUNTY AUDITOR
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If 6uyuig on tontraa, Fee Simple ownefs name
Retorders affica where contraq is recarded
Recortl number � Page
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Cwoty Tawnship Tacing dislritl (ci � wnship
� � Q , O Q Legal descnD�ion Is the property in .
Real pmperty ❑ MobJe Homo (/.C. 67J4)
If any portion oi Ne residenUal structure w tha Wnd not exceeding one (7) acre t�at immeEiatey wrtounds thei swGUre is used to D��uce inwme, desuiba �he use and portion
of the properry utilized to produce inwme.
County
I hereby certify the above statements are true, correcl and complete.
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AdOress fnumbei and streef, cif�sfafe, Z1P code)
?3�`*�'} y�. i ASSESSOR�USE ON Y-.
f:,.ui'�'" " �.. ! w : Y;a°,
Land not exceeding 1(one) acre immediately
surrounding residenGal improvements.
Other land
T�tal land (line 7 plus line 2)
Dwelling
Residentiel improvements orMnualiy
Assessed Mobile / ManufacNred Hwne Garage
Other improvements
Tolal improvements (line 4 fh�ouqh line 6)
Tclal value (line 3 phs line 7j
I hereby certify Ihe above is true, wrreU, and
complete.
Venlying actbn - SignaWre oflwditor
SynaWre of Auditor
Signature
. TRUE TAX ASS
"� VALUE . AT
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(3)
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Signamre of Assessor
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:::�,..•.,•�•C:�-q;%?:i::. r-- - �.STANDARD.DEUUCTION
20_Pay20_ �
Lesser of V2 Homestead S
vauauon w E35.000 �
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Tavnship
STEAD ' NON-RESIUENTIAL„
UE � ,.: -s.'-. VALUE,�. .�
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Date signed
Date signed
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