HomeMy WebLinkAboutHomestead_DeffendallCLAIM FOR HOMESTEAD PROPERTY TAX FORM
YEAR
CREDIT/STANDARD DEDUCTION
♦ State Faint 5473 (R7 I SW)
Prescritied by the Depertmerit of Local Governmerd Firsance
INSTRUCTIONS: See reverse side for Nina instructions. T7TT -p-,
I (we) n—v certify that odWNIE@d* gfftrch, 20_
1 (we) occupied as our prinajpplace ��idence the foulnoescribed real property for which a Homestead Property Tam: Credit is hereby claimed:
I I (We) awned El Are buying under contract
Wave a beneficial interest in the entity that is liable for the property taxes an the property and that owns the s-b6,
yrng un&r a contract
MrON"' COUNTY At, Di-.C)P
I -Ilil- - - - - —, ,
ACT, RECORDED "., �,i4
N,CONTP �4�, W 'N )X-
if buying on contract, Fee Simple owners name,
RecordWs office where contract is reconlet! Record number Page
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County
cl
County
Township
Tacing district (city, toivri.
S stuns of dainiant
k—
M'�';.VALUE,�'
mk--(number aid strael, aly. state, ZIP Owe)
V
L, lescnWmn
I Is the property in question:
/9 27
007
1 property ❑ MoNl.Ho.Q.C.Cj
of the not exceeding am (1) sore that irriniediately wrin:iunds Own stit2tiire Is used to prod" income, describe the use and portion
of Ne y liz to proluas ir�na.
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County
Township
County
Township
I hereby certify the above statements are true. correct and complete.
S stuns of dainiant
1,A �Tno% OF TTV'�.
M'�';.VALUE,�'
mk--(number aid strael, aly. state, ZIP Owe)
V
I (, LU
C4,-L,
41
20 _ Pay 20 _
Lesser of 12 Homestead
Valuation or 535,000
TRUEMAX,,:,!,�,-�,�
ASSESSED VALUE
HOMESTEAD 'If!
2
La. -
ass N 0 N 4 ZES I D EN
;�4 yum
1,A �Tno% OF TTV'�.
M'�';.VALUE,�'
Land not exceeding I (one) acre immediately
V,,v
surrounding residential improvements.
Omer land
(2)
Trial land (line 1 plus &to 2)
(3)
Residential improvements or Annually
Dwelling
(4)
Garage
(5)
4 m
1 ia
IN, vWt IR
Assessed Mobile I Manufactured Home
W—M
Other improvements
(6)
gx'@,
Tctal improvements (roe 4 through Erie 6)
(7)
TctW value (fine 3 phs Une 7)
(8)
I hereby carfify the above is true, coned. and
Signature of Assessor
Date signed
complete.
Vorlprig adJon - Signature of ALKlittir
Date signed
20 _ Pay 20 _
Lesser of 12 Homestead
Valuation or 535,000