Homestead_RodockerCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R8 17-07)
•� . ,. ! Prescribed by the Department of Loral Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
NOV 0 2008 9
YEAR
/ ^, - -UN I Y AUIII
I (We) �(n y� //7' certify that on the T day of March, 20
1 (W— occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
owned ❑ Are buying under contract
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 on contract, Fee Simple owner's name
office where contract is recorded
County
Township
Record number I Page
Parcel number Leq descnpbon r O Is the property in question:
/l- /.7 -/ 7 I ❑ Real property Mobile Home (IC 6-1.1 -7)
If any portion of the residential structure or the land not diceeding 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.
Q (0 -i y -/ 1 -16 a - ooa. a ys -od7
27_ pay 20
Lesser of 1 /2
Homestead Valuation
or /
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012 $
43,000 for 2009 pay 2010 40,000 payable after 2012
day,
Land not exceeding 1 (one) acre immediately
`-
surroundingresidentialimprovements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements or Annually
Dwelling
(4)
Assessed Mobile I Manufactured Home
-
Garage
(3)
-- - .
Other improvements
(6)
-
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 pits fine 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed (month. day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day, year)
27_ pay 20
Lesser of 1 /2
Homestead Valuation
or /
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012 $
43,000 for 2009 pay 2010 40,000 payable after 2012
day,