HomeMy WebLinkAboutHomestead_JenkinsCLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
State Form 5473 (8614 -03)
Prescribed by the Department of Loral Government Finenpe
® INSTRUCTIONS: See foaarm atdo for Mhg iubucdona
J"
FORM YEAR
HC70
I�uv i $y�nn5
(We) cerG that on the 1s da t March, 20
I (We) occupied as our principal pla res ence the following described real property for which a Homestead Property Tax Credit iiss hereby claimed:
El I (We) owned ❑ Are buying under contract '" xz
Have a beneficial interest in the entity hat is liable for the roe taxes on the roe and that owns the r2o� a is •'°n Adderia contract
ty property rtY property rty P PertY �M 9
NTRAC_TRECOR_DED
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
low F Mirk eTez'ti+{S i1N 0. art=. .t "p$'* i• ri-1 -�.c:. F-�j _
.STANDARD'DEDUCTION ALI. OWAIiCE., ����,. � ,t�,.s�.t;.`�,a•Z'3- ��"i��` -?
20 _Pay 20
Lesser of 112 Homestead
vauatton or f35.000
gna re uw Date �gned /�
Coun
Township
Taking district (city, town, ns "
P I mbar l S �
eg
tyettti,,, _
�' )' 1
she property in question:
(�• Real property ❑ Mobile Home
C 61.7 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immedi I surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
County
Township
County Township
I hereby certify the above statements are We, correct and complete.
S e 7mant
ss (number and street, city, state, ZIP code)
I- r.�,i, ... ms'ly-/ii >�..- i..ee3
T ASSESSORiUSE ONLY_ z 3-u
s}S, -,off 'tt$S.�F*.',.�"s
> •yy.
TRUETAXi
VALUE a E
ASSESSEDVALUE.
sATt700 %y0 �TTV,,,r`,VALUE
a..
' HOMESTFI/D
-
W NItESIDENTL4L
- `- e•VALUE aya',�'e
surrounding residential immediately
tial impro ements
Other land
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements or Annually
Asessed Mobile I Manufactured Horo
Dwelling
Garage
(q)
(5)
q. s„
Eli, s
IWO
,�..
t ` fr , r_
--s ,
a le
Other improvements
(6)
2 tix�vi
Total improvements (line 4 through line 6)
(7)
at value (line 3 plus line 7)
(S)
I hereby certify the above is We, tbmeot, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
low F Mirk eTez'ti+{S i1N 0. art=. .t "p$'* i• ri-1 -�.c:. F-�j _
.STANDARD'DEDUCTION ALI. OWAIiCE., ����,. � ,t�,.s�.t;.`�,a•Z'3- ��"i��` -?
20 _Pay 20
Lesser of 112 Homestead
vauatton or f35.000
gna re uw Date �gned /�