HomeMy WebLinkAboutHomestead_Phillips (10)rt
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (RS 14-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
II ,
I (We) certify that on Q §t d4 of March, 20 _
(We) occupied as our principaoace of residence titA following 4fescribed real PrOP96Y for which a Homestead Property Tat Credit is h/ Ieby dal I d
El (We) owned E3 Are buying under contract r j� RUptjp9
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the pro . 3Q�s,buyUtg'tinder a contract.
`CONTRACT. RECORDED:' +`TS;iD�a'rt
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
g 'k z a €P.ItOPEttTY OWNED, BY, CL''.41MA
RT. Y: DESCRIP .T10Nft��#7 +- ''r.V.,,3+�. -a a .. p ��r�. `�.aF'..� `'�,- zit•..
County
Township
County Township
Taring district (p'!a to . township)
Parcel number
—
Legal description
/
(p
Is the property in lion:
Real property Mobile Home (I.C. &1.1 -7)
Hwy portion of the residential structure or the land not exceed'
of the property utilized to produce income.
o (1) as that immed rely surrounds that structure is used b produce income, describe the use and portion
y
�/J,/C�
g 'k z a €P.ItOPEttTY OWNED, BY, CL''.41MA
NT, IkbTHERCOUNTIES �'YJ�' +� 1.r y +t fTT RF✓�nAS;;
County
Twvnship —
County Township
I hereby certify the above statements are true, correct and complete.
Signa re r da' a n
/r
Address (number and street, city, state, ZIP code)
Omi. 1F ...'.
.
TRUEw�.TAXu r�
e «- ...`..�...-�.,
ASSESSEDNAUIE
�..,. a.....
HOIdEBTEAD
�r, �..
..*.INONjiE81DENTIAL a
„••,
_
..< A.V_ALUE -c,...
Land not exceeding 1 (one) acre immediately
surrounding residential Improvements.
t�;'d,{•,,��;;§§ .:�y- e7`• <.'•,':
Other land
Total land (line I plus line 2)
(3)
Dwelling
(4)
1
'`S c,- eci,:ii•,XLS,YiJ -1,� �'�Y��Y>FSYM1f..'-'.i�.:1
?, 3s; ;3`i�,$s.anYxs)'�'�u'.
Residential Improvements or Annually
Atoesved Mobile I ManufacUUed Horne
Garage
_
u �zpN. G3�t
Other improvements
(6)
+'.'` -�'r %: „_•� :L�':
Trial improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(g)
1 hereby certify the above is title, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
.-
40 ., c Y'-f' - i.-+w, x i - F'�.^'R5v Ga•"yyx _ - - .• i.ac!t -Fi_ _ i. yk a r.-.�� .
*W1 r- r+'`i }:z.eb3r- ,�fa;_:!'N. } >s.. .�?rs£ >. STANDARD) DEDUCTION'AL'LOWANCE.._...::s!.
20 _ Pay 20
Lesser of 112 Homestead
Vautlbdit of 535.000 S
Signature of Auddor Date signed