HomeMy WebLinkAboutHomestead_Blevins 1,'t, CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
.� 1 STANDARD 3SUPPLEMENTAL DEDUCTION H M li '
Prescribed by the Department of Local Government Finance 4
It "'CTIONS:See reverse side for filing instructions.
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ill,, " Tn -_ t'-„t"" a WISYSERTIICATION:STATEMET :::-E :51; vtbr !iq.%)u4tief$1' t i +_-,_5,
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certify that I(we)ocr<pied "'�y(nnrr)))ppdncipal
plan �:dence or am(are) . 'ng the following described real property for which a Homestead Property Tax Standard Deduction is chimed
•
er anlract on the date this application is filed, (date of filing). I(We): GIBBON COUNTY
AUDITOR
Own ❑ Am(are)buying under recorded contract
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
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If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
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County Township TStrid(city,town,towqnnshih�)
:number Legal /�ipodon [5 / Is the in question:
�m('�/i�/1 626.2° Q(9 / Real property ❑ Annually assessed mobile Iona(IC 6-1.1-7)
If any portion of the residential structure or the landnonott xxceeding one(1)acre that immeditttt11 structure a used to produce income,describe the use and portion
e property utilized to produce Intone.
6- /3 - do-/O/-00o. 02/9-G?1s
,.w.z�.;5.^ ax rk..C.!^'.q. ;`'i4V1',1_.-;}1i_PROPERT.YOWNED;BY,CLfAIMANTi lN OTHER;COUNTIES-.-?".itSNi&x,_. :.:..;. .,.,a;::L.Y1:-NT
County Township County Township•
I hereby certify the above statements are true,correct and complete. Sig lure of nt
Address(number and street city,state,and ZIP code) /%;��.//�/t�.
r W s r f e s; • -r 9 6 91
*Z S`.i + '�a '" .t ° Sit 'i �ci_t Art P" '�ASSESSED VALUE I a'HOMESTEAD:r} 4 NON RESIDENTIAL -. - 4'
:1 i yv r ASSESSOR USE-.ONL7.5i1�iaiti'isi' `lie mTN(LVALUE _AT'100 . OF.T.TVa':a ,IVALUE 't s�u'F.'?Ti 't-VALUE cis :?-r
Land not exceeding 1(one)acre Immediately t' j'`r"3 v
surrounding residential improvements. (1) _ + c s 4
x` t'
Other land (2) ; f_- Li
-{a ^-:
Total land(line 1 plus line 2) (3)
.',a ter, �"€:, -i-iitr;
Residential improvements or Annually Dwelling (4) r, "-' *Lys Yr,
Assessed Mobile/Manufactured Home " ' ^r ° WGarage (5) k .
e..;-7,4
Other Improvements (6)
re... -Xc, sue,'':
Total improvements(line 4 through line 6) (7)
®I value (line 3 plus line 7) (8)
nereby certify the above Is bus,correct, Signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
t= / `i=.; � <a 'ti tr 'it t E,k`d'STANOARDDEDUCTIOIJ�ALLOWANCE 'T =- aT 4--i - r >9 ,Z m .•,e.
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20 pay 20 _ Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other provision,the sum of the deductions provided in 10 6-1.1-12 to a mobile home that B $
not assessed as real emptily or to a manufactured home that is not assessed as real property may not exceed
one-hatl(12)of the assessed value of the mobile home or manufactured home.
Signature of Auditor
Date signed(month,day,year)
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