HomeMy WebLinkAboutHomestead_NevillCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
` Sate Form 5473 (R817 -07)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
YEAR
�A HC10 �.
1 J
I (We) J certify that on the 1 st day of March, 20_
I (We) occupied as our principal plake of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
—� I (We) owned ❑ Are buying under contract
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 under a contract.
• . -. .
If buying an contract, Fee Simple owners name
Recorders office where contact is recorded Record number Page
County
Township
County
I hereby certify the above statements are true, correct and complete. Slgna¢rre of daimant 0 c__—V,
ZIP code)
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
Total land (line 1 plus lone 2)
Residential improvements or Annually Dwelling
Assessed Mobile I Manufactured Home
Garage
All 76
npo 0;Z/ q o f.
ll� QQ 00' -
(4 Vals
(5)
Township
1 '~
y �r
Other improvements
(6) -
Trial improvements (fine 4 through fine 6)
Lesser 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation
PROPERTY DESCRIPTION
County
Township
Testing district (city, wn, township)
Parcel number
Legal descriptio�n
/ ,�a S A �, Is the property in question:
77
�� Gf/
17-A-9 ❑ Real property ❑ Mobile Flom (1C 6-1.1 -7)
I
o arty portion of the residential structure or the
of the property utilized to produce income.
land not exceeding
one (1) acre that immediately surrounds that structure is used to produce Income, describe the use and portion
,y 67-/4- / 9_ /0 �i -0
County
Township
County
I hereby certify the above statements are true, correct and complete. Slgna¢rre of daimant 0 c__—V,
ZIP code)
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
Total land (line 1 plus lone 2)
Residential improvements or Annually Dwelling
Assessed Mobile I Manufactured Home
Garage
All 76
npo 0;Z/ q o f.
ll� QQ 00' -
(4 Vals
(5)
Township
1 '~
y �r
Other improvements
(6) -
Trial improvements (fine 4 through fine 6)
Lesser 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation
(7)
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Total value (line 3 plus line 7)
Signature of Auditor
(8)
I hereby certify the above is true, correct, and
Signature of Assesses
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day, year)
STANDARD DEDUCTION
pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation
$
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor
fate signed (month, day, year)
R