Homestead_HurlockCLAIM FOR HOMESTEAD PROPERTY TAX (��� FORM
CREDIT /STANDARD DEDUCTION 1 HC10
State Form 5473 (R6 / 4-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instmclions,
I (We) V L/ - . certify that on the 1 st day of
I (We) occupied as out principal I ce of residence the following described real property for which a Homestead Property Tax Credi['is 1
❑ I (We) owned ❑ Are buying under contract i�! %-fJ%
G5SON CCUt6T
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying un
YEAR
sItiCONTRACT :'.RECORDED'.ui`T'i�'TJYa'F».
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
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_ '• ASSESSOR USE ON Y y a„�
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YYSfiF 4P
';o _y<� -�,>3 P,R0 ?ERT.Y:DESCRIPTION�'. �- sF�:.�., . t >tx .�. <. ; ,- r.�:•��i�.' -.�
Coun
County Township
Township
Taring district (ri tow
\pare
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Peel
poportion
-�
Legal tles bon D
/� �
is the property inRealsproperty ❑ Mobile (/.C. 6 -1.f -n
If any portion of the residential structure or the land not exceeding one (1) acre tat imnledialfily
of the property utilized to produce income.
surrounds that structure is used to produce income, describe the use and portion
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County
Township
County Township
I hereby certify the above statements true, correct and complete.
ature of claimant
\pare
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_ '• ASSESSOR USE ON Y y a„�
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'4. -., x
' TRUE TAXI
ASSESSED VALUE
a=s..
�HOMESTEAD�
NON= RESIDENTUIL � �+
�
j.° +a`e✓'i_".
VALUE_r.'::ay.,,,
.AT 100 %`OF�'TfV
". �= tVALUEr s,
r �yyAL.up
Land not exceeding 1 (one) acre immediatelyh,,�s,�`F'+
surrounding residential improvements.
Other land°--
r�
a
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
DA
f 3.E.0a
Residential improvements or Annually'-
'""_'
Assessed Mobile / Manufactured Home
Garage
(5)
k%�e
Other improvements
(6)
-''-'
F'?? }A T.. ��.'..
Total improvements (line 4 through line 6)
(T)
Total value (line 3 plus line 7)
(6)
hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
vin - Y S yw. ;may.
DARD DEDUCTION` ALLOWANCE. S��.. sywil?�..as"�°+�`-- ?�r"..�;�=
20_Pay 20_ r
Lesser of 1t2 Homestead S
Valuation or 535.000
S' t Puddor Dale