HomeMy WebLinkAboutHomestead_Hill (5)'°" CLAIM FOR HOMESTEAD PROPERTY TAX
__ � STANDARD / SUPPLEMENTAL DEDUCTION
' State Form 5473 (R13 / 12-09)
� y� PresaiDed by the Department of local Gwemment Finance
FORM Y�
HC10
INSTRUCTIONS: See 2verse side (orfiling insWctions ���
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I(We) certify that I(we oaupi as my our7 pnndpal
place of residence or am (are) buying ihe following described al property fw which a Homestead Property Tax Standard q�t�Gtiq� {� hp�peJry daimed
�er contract on the date this applicalion is filed, (date of filing). 1(We): �� � I � G LU 1
Own ❑ Am (are) buying under recoNed conVact C.�.M-'�;�
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❑ Am (are) entitled to occupy as a tenen45tockholder oi a cooperative housing corporation V
❑ Have a beneficial interest in Me Wst or the nght to occupy ihe property under ihe tertns of a qualified persong6�Q}'���(�ftlTY AUD1fi8E7
❑ Am (are) the shareholder, partner or member of the entity tha� owns the property.
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Name of dai t(/ega! name) ,
sodal Senuity �� �ssuirg e
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Nama ol dalman�'s s nle9,al nartre)
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Sodal Sefvriry
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It buying on contraa, Fee Simple owners nama
Recordels of6ce where contraG is `ecorded Record numbu Page
..e. . � . �
��{y / ` / � Twmship Tating . . town. to shiP)
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Patcel number Legal desaiption �s the pmperry in ques'
�p? � Real pioperty Mnualy assesseA moblle Mme (IC 61.1-7)
If any portion of tl�e residentlal sW cture or the IarM not ezceeding rn 1 cre ihat immediately surtounds ihat sWClure is u o produce income, Oesaibe the use antl portion
o( tha property utilized tn protluce Income.
�'-/3-/d /o"d -GY/D. 0�,3 -cY�G
... . . : . .
Coun Tamship Caunry 7ownship
I hereby certify the above statements are We, cortect and mmplete. Signawre of nt -
Ad (numbe� and sfreet, dry, sfafe, arid Z/P e) 1 , [_� �
6 "
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Land not esceeding 7(orre) acre Immedlatery �`n �, �,�':'� Y -,,,v` �
surtoundln realtlentlalim rovements. ��) ��' � ''V+°-� �" '�1:"
Y.� "`+ io���k
Othar land (z) ,..u,4_.._�.-i�..;°.
Total land (line 1 plus line T) (3)
- �' Y� Tr y':- ��i''� ' �'�
ResideMialimprovementsorAnnually ��Iing (4) r .�,��z��.�,-�. ,�.,�3.=;
0.ssessed Mobile I Manufac�rad Home �^' � '` �"� �- �?
Gaage (5) .,r# � �; _:.`"`��}a..i✓��� ,::
-. a.=......__„�._:._�.
>-r � c ',�c. `'.
Otherimprovements (6) .��-l�, '+"�
Total improvemeMS (line / through line � (7)
Total value (line 3 plus line 7� (8)
I hereby certify the above Is We, correct, �9^a�re oiwuessor Date signea (monfn, dey, yea�
and eomplete.
Veriyin9 action - Signawre of Autlitnr Date si9ned (rtanth, day, yea�
�.•� � � • •
20 _ pay 20 _ Lesser ot 60% of the essessed valua of the homestead or $45,000
Nolwifhstanding anyWheipovision, the sum of fhe deductio�n provided in /C 61.7-12 fo a mobile home Maf is $
rw! essessed es real pioperty w to e menWactured home fhet is nat essessed as 2a/Oroperfy maY not exceed
one-hafl (12) o7Ne assassed ra/ue o/the mobile hane ormanufactured home.
Signawre oflwditw Date signed (month, day.Yea�
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