Homestead_HintonCLAIM FOR HOMESTEAD PROPERTY TAX
FORM YEAR
CREDIT/STANDARD DEDUCTION - HC10
State Form $473 (R614-03)
Presented by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
I (we) Lft-t�e" T"Ify atc h-ei, sy March, 20
I which a t IL sit
I (We) occupied as our principal place of residence the following described real property for _Fmest d EC )hereby claimed:
❑ l(We)owned ❑ Are buying under contract
IHave a beneficial interest in the entity that is liable for the property taxes on the property and that ownsMAjroI1e4 AMDuying under a contract.
If buying on contract, Fee Simple twmees name
contract is recorded
Record number I Page
j-U:�". P40PERT—Y. 0 ES C Rl PTION
County
Township
County
71:;�
County
Township~
dress (number and street city, state, ZIP code)
Turing district (wf)4 to", township)
-IYALLJEMN��A
Paroet
Aib-006,39-u)
number
I P9criptj?n
I
ho
Is the property In question:
I P�
(2)
❑ Real property
❑ Mobile Home (LC. 6-1.1-7)
If any Portion Of the residential Structure Of the land not ex
at surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produoe Income.
AS A
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant
dress (number and street city, state, ZIP code)
AS A
-Trui-i��'�X 'ASSESSED
�E V
�iliHOMEST EAD
N
Valuation or 535,000
$
�A
7'1�t
-IYALLJEMN��A
Land not exceeding I (one) acre immediately
surrounding residential Improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements or Annually
Dwelling
(4)
1^.
Assessed Mobile I Manufactured Home
Garage
(5)
—2�
,V];er improvements
(6)
Total Improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7) .
(8)
I hereby certify the above is true, correct, and
Sigrummi of Assessor
Data signed
complete.
VedfAN action - Signature of Auditor
Date signed
-�; 4 STANDARD: OWA N CE
20_Pay2O_
Lesser of 1/2 Homestead
Valuation or 535,000
$
Signature of Auditor
Date signed 5--W -Ovs7
a