Homestead_RobinsonCLAIM FOR HOMESTEAD PROPERTY TAX
CREDMSTANDARD DEDUCTION
State Form 5473 (R71 5-M
Presabed by the Depwbrmd cf Local Governmut Fr
INSTRUCTIONS: See reverse side for filing instructions.
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CERTIF{CA7= STA7FJIENT;
1.
I (We) _ n certify that on tlt@i'�de of M�i 2D"
O � i7— ,
I (We) ocah f' as principal place of residence the to rig described real property for which a Homestead Properly TIM y�a�
rTOR
I (We) owned ❑ Are buy"vg under contract
Have a beneficial interest in the enti y that is liable for the property taxes on the properly and that ems the property or is buying urder a contract
r..` '-CONTRACT RECORDEDt.$• ?r`
t buy'vg on .tract Fee Simrale awnefs name
Re� a@ra where contract u recerde0 Recmd number Page
k. ,,:?•PROPERTY OWNEDBYCLABiANT Or OTHER•COt1NT�Sr, .^.,. %' ..�tt }'<Y 'f'•�'"�:ih�?:�'^.': <t€,`:'
.PROPERTY DESCRIPTIONIq': � t'; f:�,- n <_.. >'. ..�1 r�i, ,5, r'b'c ^'�'er•`Jr <+ � F;'i �.?`
.
Canty
TaNnstup
of clamant r
Tamg district ( . lam. tomshfp)
t VALUE,
(number and street city. slam. ZIPcode)
t VALUE
ye�..f,'�
Farrel rsurber
Legal desenpbxn
is the property in question.
Y,: ...h ? .1
❑ Real properly 'le Horne (LC. &1. 1-7)
podon of the n the land nal exceeding one (1) that it nexiaENy sunnumis that a is used to produce inm ne . describe the use and pv6on
of Y ue�r produce
aL,- 14- ic6 -ioa- 006.
logtn - 00 -7
k. ,,:?•PROPERTY OWNEDBYCLABiANT Or OTHER•COt1NT�Sr, .^.,. %' ..�tt }'<Y 'f'•�'"�:ih�?:�'^.': <t€,`:'
County Tmnship
County Township
1 hereby cedi(y the above staterrlerlts are true, correct and compteta.
of clamant r
SE
5 n ASSESSOR U ONLY ri
t VALUE,
(number and street city. slam. ZIPcode)
t VALUE
a r r
r TRUE TAX-
ASSESSED VALUE
FIO5 MESTEAD `-
'nj a} NON�RESR)EENN7IAC'9
SE
5 n ASSESSOR U ONLY ri
t VALUE,
"'AT 10D% OF TTV
t VALUE
ye�..f,'�
,,. A,, nk", t q` . yi
w
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Land not exceeding 1 (one) sae imrediatey
(,v+fh g r
Sid,
slarOlIIldPg resldentlal IfrlpraYefrlellt4.
(1)
��: N }d+.�.N n 'a8 :ti.$. 1
Other land
2
Tdal tend (Iim 1 plus 6he 2)
(3)
Dwelling
a� 5
.',ty ,'#.'KKl #t 41Y (},��r-q 'T ?1,
Residential bnprovenmts or Anmialty
(4)
v`.A't'
Assessed Alohde / W undaftYed Fiore
Garage
(5)
�3•'
Other anprovements
(t)
c.r. .
t 5 '.•. Ott' T
#.
Tdal bnprovernerds (fire 4 through Orre 6)
(7)
Total value (fare 3 plus One 7)
(8)
I thereby ce" the above is true, correct, and
cwPkft-
Sig%*" of Assessor
Date sged
Vedlying action - Signabae of Audtar -
Dam signed
. 1;• STANDARD DEDUCTION ALLOWANCE,: '"'3•.'.'t'`A. < 74.. ti� {`;�";"ff'.
20 _ Pay 2O
Lesser of M Horrestsad
s
Vaivation or s35,000
s Au6tar
Date sWmd
-:3 (0 0�