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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
State Form 5473 (R7I SM
Prescribed by the Deperbrerd of Local Goverment Finance
INSTRUC77ONS: see reverse side fir Ring (nsjnj 8 ns.
FEB 5 2008
cERTUICAnoN srA
I (We) Y fY tl I JYT AU IT�R
I (We) occupied as our principal place of residence the following describecI66al property for which a Homestead Property Tax Credl is hereby daimed: -
I (We) owned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the properly tuxes on the property and that owns the property or is buying under a contact
CONTRACTRECORDED•`;.:
d buyerg on contrail, Fee Simple owner's name
Recorder's dwe where contract is recorded Record number Page
.. .. _
-...
-. PROPERTY DESCRIPTION •. - . - -. ? _.':::, ' , _ 't °v S+':R.�
Corny
Towsldp
I hereby certify the above stalerrertts ate true, carted and complete.
T isfricl (c7y: lawn. t ) '
Pared number
L description
p p 170113
! c
pr question:
the Property it
❑ Raw property ❑ Nohtb Home (LC. 61.1 -7)
portion of the residadal structure or the lard nil auceedng one (1) ace that immediately surrounds that structure is used to prod" income, describe the ule and portion
property utr1®d to produce income.
C26- !(f- /7 -d00
-000.
yS's -ooh
•:'. ,..`•.. ;:1 . ... ::PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES-;-,
County
Township
County
Township
I hereby certify the above stalerrertts ate true, carted and complete.
°f
';AT100%OFTTV '
(number and street nty- &31a, ZIP code)
t S 13 6a—
:,,ASSESSOR U
TRUE.TAX A
ASSN VALUE F
FSTEAD e
e T NONAE9DENTIAL+,�.
USE ONLY ,; -
VALUE '
';AT100%OFTTV '
'. VALUE
Land not exceeding 1 (one) acre inmredatey
surrounding residential improvernents-
Other lard
O
O 2
=
Total land (line 1 plus 6na 2) (
(3)
Residential "vnprovencnts err AnmWly (
Dwelling
(4)
Assessed Mobile I Manufactured Home
Garage (
( )
Other bnprover ents (
(6)
Total unprovernerds (fie 4 through fine 6) (
(7)
Teal value (Ide 3 plus fine 7) (
(6)
1 hereby certify the above is true, carted, and S
Signetwe of Assessor D
Data signed
%Awdymg action - Signature of Audmr D
Data signed
:STANDARD DEDUCTION ALLOYVANCE � .
20 _ Pay 20 _
Lesser of 12 Homestead
Valuation or 535.000 $
Signature of Auditer Date sgned