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CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
CREDIT /STANDARD DEDUCTION I -
State Form 6473 (R6 / 4-03) ly
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: see reverse side for rding inshnuctions. JUL 1 3 2006
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q! •I_fiCERTIFICATIONSTATEMENTz."-'-
I (We) cerWBWpiniftUlR"AqjMj5� 20_
-Z) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
(We) owned ❑ Are buying under contract
bHave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
ONTRACT.'RECORDED
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
kOPERTY.'DE CF&T ON
S i
County
60 Ob
Township
Township
Taxing s ct I , townsh
Par
I hereby certify the above statements are true, correct and complete.
W27"
`ddress (number and street, city, state, ZIP code)
Is the property in question:
Land not exceeding 1 (one) acre immediately
Real property Mobile 11orm ( 1r. 9 1-1-7)
If any portion of the residential structure or the land not exceeding one (1) acre at'
made s that cture is used to produce income, describe the use and portion
of the property ufilh,sd to produce, income.
MM
Wg ..
Other land
-C4 RD VE RTY, OWN E D RY ' C Ek I WA 14-, I W6T 14 Ek -10-613 N TIES V
20 _ Pay 20_
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant
`ddress (number and street, city, state, ZIP code)
-STANDARDDEDUCTIONALLowANCE
20 _ Pay 20_
D' VALUE
;ROMESTFADte
)jpo N 0 9'R�ffiiNrLA%F%
�A.!�qoo ,q W.
-V -UE(%
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"aA ld�!& �W
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Land not exceeding 1 (one) acre immediately
S ) ... u,
surrounding residential improvements.
Wg ..
Other land
(2)
Total land (fine I plus line 2)
(3)
IResidential
Dwelling
(4)
G
improvements or Annually
Assessed Mobile I Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
-STANDARDDEDUCTIONALLowANCE
20 _ Pay 20_
Lesser of 112 Homestead
vauatim or S35.000
Signature of Auditor
Date signed