Homestead_Mallory7
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R6 / 4-03)
Presrnbed by the Department of Looal Government Finance
rucTrar rr•rrnuc coo .e„e.ro �:,e R., m:....:.........r:.....
r' if VI
I (We) /Y / certify that on the 1st day of March, 20_
I (We) occupied as our principal place of residence the followin scribed real property for which a Homestead Pilailty %&12 as hereby claimed:
❑ l(We)owned ❑ Are buying under contract yy
Have a beneficial interest in the entity that is liable for the Property taxes on the property and that owns the property ' or-is'buytrigrunder a contract.
s•:• ;3 a'e?�.;t''ell�`'. CONTRACT! RECORDED'' �ss' �-.€ c. �' ���# �- s§J:T3�= �'.�+���.i;�x.�-s.�'�9 ar ref?
If buying on contract, Fee Simple ownees name
Recorder's office where contract is recorded Record number Page
..e•-�,'�iY .%> f.+, �_- �;- �"' �" �." i�r, P, ROP. ERTMsBESCRIPTION�.` �.' ? r�,+ �' ;>'�a'�.���;.�s�"a''"'�.�;�t;G:
County
Township
Toting district (city, town, to ip) 17 L
Parcel nUU X, _ / 6.%— V
Le al description
Is the P cry in question:
Real property ❑ Mobile H .C. 6- 1.1.7)
If my portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
1 --'u`" W�'"'.._�.- .�?k'�i'_��t++ G?PROP, ERTY; OWNEDBI 'CL'AIMANT?IN'OTFiER`COIIfJTIES
County Township
County Township
I hereby certify the above statements are We, correct and complete.
ignature r aima /
v
^Address (number an, s1b/ee(, crty, state, ZlP code)
a/-55 'nC S�fc2
c�" ASSESSOR USE }ONLY
'TRUE TAX r -fit.
;VALUEte -tS,y
ASSESSED VALUE.
AT.100%OFeTTV
HOMESTEAJD
VALUE 3
` NON4RESIOENTWL
'VALUE #Lir't..
Land not exceeding 1 (one) acre immediately
S
at a ditor
Date si ed
a 9-ob
surrounding residential improvements.
Other land
(2 )":
�1 MU
Total (and (line 1 plus fine 2)
(3)
Dwelling
(4)
`}, -" .: -t`- ".
Residential improvement or Annually
Assessed Mobile / Manufactured Home
Garage
(5)
ry63janY,�����
Other improvements
(6)
w`v����rt vii
Trial improvement (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
-STANDARD DE�UCTiON ALLOVANCE_ 'T0Y ?
'�.�;5y„vas. % � $A [�� , 1. .„ 7 =- ,
20 _ Pay 20
Lesser of 1/2 Homestead
Valuation or S35.000
S
at a ditor
Date si ed
a 9-ob
0 �