HomeMy WebLinkAboutHomestead_EhmkeCLAIM FOR HOMESTEAD PROPERTY TAX YEAR
sA -• _ CREDIT /STANDARD DEDUCTION H o
State Form 5473 (R817 -07)
r, u•
prescribed by the Department of Local Government Finance
INSTRUCTIONS. See reverse side for filing instructions. S E P 2 2008
1 (We) _:,J"I�orI641% ( j� certify ��gqthacat on th�s[Tda% 'MM�a7rch, 20_
1 (We) occupied as our principal place of residence the following described real property for which a HomesteaPrbgr W.l: AYWRklaimed:
rI (We) owned ❑ Are buying under contact
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the prop" or is buying under a contact.
Parcel number
Legal description
( Is the
in queAi ton: r I
Land not exceeding 1 (one) acre immediately
eal property /Mobile Home (IC 6-1.1 -7)
11 arty a residential structure or the land not exceeding one (1) acre that immediately surrounds that
ure is used to produce income, describe the use and portion
Viliof the W 'Gm b d produce income.
Other land
(2)
'r ^�ca `, sr•(4x,'r`"+, °, y� i'•- :P,ROPERTY: OWNED 'BYCLAIMAN TIN OTHER
'COUNTIES:' '= a y' • - r a ,mss.
.
104 011004 1 y,-
Z pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser 44000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestete ad d Valuation . S
or 43,000 for 2009 pay 2010 40.000 payable after 2012
Signature of Auditor
day. year)
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Trial land (line 1 plus line 2)
(3)
Dwelling
(4)
`'-
Residentiat improvements or Annually
Assessed Mobile I Manufactured Home
Garage
(5)
S -r
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is We, correct, and
signature of Assessor
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day, year)
Z pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser 44000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestete ad d Valuation . S
or 43,000 for 2009 pay 2010 40.000 payable after 2012
Signature of Auditor
day. year)