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HomeMy WebLinkAboutHomestead_HutchinsonCLAIM FOR HOMESTEAD PROPERTY TAX . CREDIT /STANDARD DEDUCTION State Farm 5473 (Re / 4-03) Prescribed by the Department of Local Government Finance INSTRUCTIONS: See revww ado for Mrip kmftcdwm I I (We) y / ° /L/ certify that of -@rig 1st@iayuf March, 20 I (We) occupi a o 'ncip p ce of residence the following described real property (or which a Homestead Property Tax�Credit Iereb daimed: ❑ 1 (We) ❑ 'ng under contract GIBBON COUNTY AUDITO Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract. z �x -ak �? CONTRACTiRECORDED?, i;! ��% �- x�''.' �+ Y'�g.Yr�S?TZ`"'s�.FSakr- y`hk+. If buying on contract. Fee Simple ownees name Recorder's office where contract is recorded Record number Page s�'- �++'i�°��a�+..�'v-rr _ �FPROP,ERT,Y.DESCRIPTIONy =T County Township T attic dry, town, t wnship) i9natur i nanj P umber _ 3 e ion F �— Is the property in question: ' L p Ed Real property ❑ Mobile Hone (I.C. 6-1.1 -7) H any portion or the resid lal structure w M ot exceeding one (1) awe that jmrrtedw(ely,wrtounds that .ru a is used to produce income. describe the use and portion of the utilized to income. /O- property produce /l �/ /J-(� Al�tj #�� -��- 0G- dGO- 6co- '29,�--006, �?'��t�+.��'r -"��� �-'w'�P�:� ?���*i�QROP.ERTY;OWNEDrBY CLAIMkNT .IN:OTHER'000NTIES,k%�y a��'",."�a�T:��az- .3`�• -<�s` .nEk < #'!k!- 1'�°�'� County Township County Township hereby certify the above statements are We, correct and complete. i9natur i nanj Address number and street, city, state, ZIP cod ) e /� Isor3o�� 1014=114,11 � SSESSOR USE ONLY yYxe. °la$ Fes ;k11>:.,.T.i¢�t* TRUE TA7C , ?�wVAL:UE,'•Sti ASSESSED VALUE WAT�100% OFTTV,�VALUErrs�e.�F'.VALU D! HOMESTEAD.F p ' INONAEStDENTVLL Land not exceeding 1 (one) acre immediately surrounding residential improvements. Other land Total land (line 1 plus line 2) (3) 'Residential Improvements or Annuagy Assessed Mobile / Manufactured Home Dwelling Garage (4) NX'z'rYSfi'E r Other improvements (6) . a. Trial improvements (line 4 through line 6) (T) Trial value (fine 3 pits line 7) (S) 1 hereby certify the above is true, correct, and complete. Signature of Assessor Date signed Verifying action - Signature of Auditor Date signed " 'f r —STAN nRO:DeoucnoNneLOwaricE. 20 _ Pay 20 _ Lesser of 1/2 Homestead $ vauaem or f35.DD0 Signature of Auditor Date signed