HomeMy WebLinkAboutHomestead_Earlse CLAIM FOR HOMESTEAD PROPERTY TAX FORM M YEAR
CREDIT /STANDARD DEDUCTION HC10 I 1
Slate Farm r ( / 1001) - e
Prescribed by y the De Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) certify that on the 1 st day of March, 26
oll
I (We upied as our principal place of residence a owing described real property for which a Homeste�Property Tai Credit is hereby. claimed:
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,(We) owned ❑ Are buying under contract .f `ittI � hLtrtTG�
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`Have a beneficial interest in the entity that is liable for the property taxes on the property and that ownst a property or is buying under a contract.
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NTRACT;RECORDEDis"
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
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zr3 vc.� .,.,;.r -�za P,ROP.ERTY DESCRIPTION
County
Township
I hereby certify the above statements are We, correct and complete.
Taring district (crty, town, township)
P I urpbe =
Le al scriDb
s Dpe in stion:
Real property ❑ Mobile Home (I.C. 6f. 1-7)
If any portion of the residential structure or the land not exceeding one 1)d
of the property uul'aed to produce income.
that immediately surrounds that structure is used to produce income, describe the use and portion
'".III,= Hi'�4"- -. ' .3?�'r'I'' -' , i� '€:'`."*°- '- PROP.ERT4bWNED'$Y CEAIMANT, IN ATNER`COUNTIES0& '— Kj;-6%
County
Township
County Township
I hereby certify the above statements are We, correct and complete.
V ature of claimant
a AAdress (number and street, city, state, ZIP code)
'` 3 3''�
r wASSESSOR
E `
r TRUE TAX,
ASSESSEOVALUE
�HOMESTEADf`-
NONRESIDENTIAL r,.
t�"� - ,as�.1,u.
MUM
VALUEy
ATx100 %�OFTTV�y
�?,','rs VALUEf�i'�x`_�i_'�'
Land not exceeding 1 (one) acre immediately
surrounding residential improvements-
()
�`sr� "rv'r• +'r"-
Other land
j
Total land (line 1 plus line 2)
(3)
Dwelling
W`° -;:1's
(q )
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Residential improvements
Garage
(6)
_^W
�2'1 '1 ,' ,•�'
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� 'V.� a
F.V
Other improvements
(6)
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Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is We, coned, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
Lesser of 1/2 Homestead
Valuation or $6,000
Signature of Auditor I Date signed