HomeMy WebLinkAboutHomestead_ErdmierCLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT/STANDARD DEDUCTION HC10
State Form 5473 (R7 I S9M
Presalbod by the Departrrmt at Local Govemnent Finance
I
INSTRUCTIONS: See reverse side for filing instructions. .
LFT)
I (we) lt-� V- f(,4 certify that on the 1 at day of lWra, 20-
I (We) occupied as our principal plow of residence the following described real property for which a Homestead Pmperty-T it Visera claimed:
(We) owned ❑ Are buying under contract
""'SON COUNTY Ayg&yact
isve a beneficial interest in the entity that is liable for the property taxes on the property and lliat owts the property or is buying un
CONTRACTMEtORDED
if buying on contract, Fee Simple oomees name
Recorder's office Where contract is recorded Record number Page
Z< PFfopERTYoEscpipmoh,
County
Towruhip
Tadng district (citK town, townsft)
Parcel ntanoor
Legal description
Is the property in question:
- / y -19 - '-/o/ -eqo/.04
3-.007
[] Rod propsity ❑ Mobile Hoine (I.C. 6-1.1-7)
If arry portion of the residential structim, or the Wrid net mceeding one (1) acre that immeclistely surrounds that StrucWre is used to prod" income, describe the use and portion
of the property ufiLmd to produce income.
C6U?d1ES1'F9orV'0J)rA �—VMTAVP
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
�'�}wV:"a`mard
�( PAA�
( nuMer and sate nty, state. ZIP coda)
:CPA.
q-7440
ME
DAFZ6DEoucTioNALLowANcEu
VALUE
H(
NON IRESIDENTLAVt
-z LAI'
Lesser of 12 Homestead
"-W
;jAT-100%'OF
WMIRRP wu
Land not exceeding 1 (one) acre immediately
Valuation or 535,000
4, ..?.r3 - W
ail -W
surrounding residential improvements.
Date signed
V1, V50 FEE
Other land
(2)
Total land (line I plus fine 2)
(3)
Dwelling
(4)
"O.R. - -
1 MINOR
Residential improvements or Annually
ii�
Garege
Assessed Mobile I Manufactured Home
(5)
N
Other irnprovemerds
(6)
Trial imparvernents (fare 4 through Hne 6)
(7)
Total value (line 3 plu; Area 7)
(8)
1 hereby car* the above is true, correct, and
SignatitreofAssesser
Date signed
complete.
Verifying aeon - Signaltze of Auditor
Date signed
DAFZ6DEoucTioNALLowANcEu
qW 20 _ Pay 20
Lesser of 12 Homestead
$
Valuation or 535,000
sgnah" of Aixfdor
Date signed