HomeMy WebLinkAboutHomestead_ChitwoodCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R71 54M
Prescribed by the Deparbrent of Local Gavenrynerd Fb
SEP 1 7 2007
f'' CERWICA
STATEMENT,.!
I (we) certify that on el S�tw If 46. 20�_
1 (We) occupied as our principal place Of residence the following describeWreall property for which a Homestead
) owned ❑ Are Wybv under contract
Haive a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is Wying under a contract-
.,11 CONTRACTRECORDED,;�e
tf buying an ..b Fm Sanple ownees name
Recarder's office where contract isrecar Record number Page
.,..-'- PROPERTY qEsqRvnoW:'
County
Coady
Toornship
Township
Taring district (cily,
1
ti
04
Parcel number
Legal � 'Pricr'
Sipsahue of &4&wr
Data sigrned
`e;0n
V)PJ424
1'sft"5��ff'qu�
If any portion of the remlerZurl sOucture or the lard not exceeding
ads (1) vAe th[d mradiately suffourids 0131
W ' m used to produce describe the use and pa bon
of the properly, Wilized tD produce InCOfDe.
—,Yet'—
Other hind
i "-I 1 -1- - .� ;� , . 1; 1.- 1. � I � I '�
wt � . ,, - " . vkiv , , PRopmtry mmEd ey, cu DAN O_ bmim coumirs
County
Township
County
Township
I hereby certify the above staternents are true. correct and cornplete. .
Skmahi cd
re
)�
ir(nurnuer and street. dry; st3h% ZIP code)
is ;sraNDARD DEDUCTION AU:OWMCE'-
-T�FUE TAX
ASSESSED VALUE
kdlaiiiAD
—W�
ILUE�
,,,VALUE
V.*;abm or MOW
Sipsahue of &4&wr
Data sigrned
Lend W exceeding I (one) acre iffwTmxfiat*
surrounding residential improvements.
Other hind
(2)
Tdal land (Anne I phis Arm 2)
(3)
Dwelling
(4)
ResdentialtimpnmriernerdsorAnnxially
4 W2
Assessed MobiFe I Marelfacturad Hone
Garage
Other imp"wernents;
(6)
Tdal (Lbe 4 Iftrotio fine 6)
(7)
Thal value (few 3 plus One 7)
(8)
I hereby ca" the above is Due, correct and
cornpleta.
SW%sture of Assessor
Date so
Verifying action - Signature of Auditor
Date signed
is ;sraNDARD DEDUCTION AU:OWMCE'-
20_ Pay 2O_
Lesser of 12 Homestead
V.*;abm or MOW
Sipsahue of &4&wr
Data sigrned