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HomeMy WebLinkAboutHomestead_Helsley (2)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR CREDIT /STANDARD DEDUCTION State Forrn 5473 (R7 /5M Prescribed by the Deperbriard of Local Govenvnerd Ft INSTRUCTIONS: See reverse side for Ming insfructions. I (we) Y )KA A cerfif�hal a*�daj'�, W_ I (We) occupied as our principal place "es=admd property �� the"fbol !'n—g d— V;proiperty i,;r which , Homestead Property Tax Credit is herebv claimed: I (We) owned ❑ Are buying under contract FEB 1 2-16 Have a beneficial interest in the enfity that is liable for the property bows on the property and that owns the property-" buying er a contract If buying on mnbaa Fee Single ownses narre ftcorder's ofico where contract is reoorded Pjxxwd number Page ,., .",.2",, PROPERTY owmEDay. CLAD/ANT tN OTHER 'COUNTIES i MWETAX PRoPERTYbEscmPnom Township County Township Tarr tip Signature of V Tang district (cOJ4 90&*qm (nww d and Street cftsfals, ZAP code) X -7 Land not exceeding 1 (one) acre immedlistalY MY. sAQe� ol4utet aa 6 0 s9lature of &6tor surroundkV resudenfial anprovements_ and amber 3a3-co Legal description, Is the poop" in question, I d(0_ 1q_ 13 . S a -0 CQ D-R.".party ❑ Mobil. H. (1(11 1-7) If any portion of the residential structure or the LvW nil exceeding one (1) sore dud intrnwieldy surrounds dud shicture is used to produce income, describe the use and portion of the property utilized to produce TOtEd land (Inns I pAris fine 2) ,., .",.2",, PROPERTY owmEDay. CLAD/ANT tN OTHER 'COUNTIES i MWETAX County Township County Township I hereby as" the above staternents are true. correct and complete. Signature of V 90&*qm (nww d and Street cftsfals, ZAP code) X -7 Land not exceeding 1 (one) acre immedlistalY MY. sAQe� ol4utet aa 6 0 'z of ASSESSOR USE MWETAX -ASSI - . D "VALUE � , -,VALUE � a ?AT -100% OF j'�W-OWRESJN W � Land not exceeding 1 (one) acre immedlistalY VakLabon or $35,000 s9lature of &6tor surroundkV resudenfial anprovements_ Data signed im Other land (2) TOtEd land (Inns I pAris fine 2) (3) Vf' Residents] irr�, ents or Annually Dwelling (4) Garage Assessed Mobile / Manufactured Home (5) Other improvements (6) Trial arpuvernents (firm 4 dmugh dine 6) (7) Tidal value (1km 3 phE One 7) (8) I hereby oarfify Vve above is true. cared, and coff1plate- Signature of Assessor Date signed wrifying action - signature of Auditor Dide signed STMDAFW MMCTM'ALL 0WANCE ow 20_ Pay 2O_ Less" of 12 Homestead $ VakLabon or $35,000 s9lature of &6tor Data signed