HomeMy WebLinkAboutHomestead_Phillips (9)} CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Forth 5473 (Ra 14-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
ILIIJ
property for which a Homestead Property Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contract - GI3SOt! CC UfdTY HUDITOR
18 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.
NTRACT'RECORDED�3"
If buying on contract, Fee Supple owners name
Recorders office where contract is recorded Record number Page
`'`,:=, r3P, ROPERTY, dESCRIP .TI0N1`°i3",Y.-`- =?a'r'S?`f3:
County
Township
Taring district (city, town, township) '
/�'�J
Parcel number
Legal scripGon
�
Is the pro rty in question:
%OF�TTVVALU.
cis�7
L.lL1's d
Real property ❑ Mobile Homo (I.C. 61.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that s cture is used to produce income. describe the use and portion
of the property utilized to produce income.
MOM P. ROPERTY; OWNEti; BY :CIAIMAWTINiOTHER`COUNTIES`'w3a
County Township
County Township
I hereby certify the above statements are true, correct and complete.
Sign ure of claimant
r
Address (number and street, city, state, ZIP code)
�in C7
' -sr• - °- -`- �'
=ASSESSOR�USE ONLYc�
'TRUE TAX '
'ASSESSEDVA ME
HONIfiSTEAD�?`
NO - RESIDENTIAL T%
kY4
>VALUE
%OF�TTVVALU.
yATi100
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Otherland
F'�•``" -f`-
"
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
M.11- z5PC-ff-
Residential improvements or Annualty
Assessed Mobile /Manufactured Home
MIX, $� °
Garage
g
(5)
� A
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
lZiV �ySTANDARf )'.DEDUCTIONiALL`OWAHCE++.�ia u.e'.` `' -_ �'�' a-
20 _ Pay 20
Lesser of 1/2 Homestead
$
Valubon or E35.000
e
Signature of Auditor D ate signed