Homestead_VoreCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R61 4-03)
Presorted by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side for filing instructions.
�0 F � YEAR
1 H�
JUL 17 2006
I (we) - V VI v 1 f1
Srruett�fhgCdUtfReY1 �t4>Q�T4 March. 20
I (We) occupied as our principal place of residence the allowing described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ l(We)owned ❑ Are buying under contract
aHave 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.
n<CONTRACTtRECORDEDs`ta'� ..K �" w } v -;s-* S-a'e"a '"'Si;Sv > 1''�'••'"'s... 's
If buying on convact. Fee Simple owners name
Recorders office where contract is recorded Record number Page
<T'] � '�V
�. P,,ROPERTY:DESCRIPTION.;; -°^�^' _
�, A' t;x _ -"LAS . ,. .'��1"'�itl?P.. i•.
+Cou
County Toomship
Tamship
I hereby certify the above statements are true. correct and complete.
Taring district (city, town, t ns
®-e um erandstreet "Y' state,2jPcade)
UU u
`` 'l`'•,VALUE,' „T� x
_AT 100% OF:TTV
r VALUE may%.
�„� �„� r VALUES
Pa I Tof r
Le al description
r �
Is the property in question:
Real property ❑ Mobile Homo ( /.C. .1 -7)
If any p the residential structure or the la ex din one (1 a
of th roperty, utilized b produce income. 02 ��
e that immediately surrounds that s cture is used to produce income, describe the use and portion
(2)-
A-13 -19-1601-col 1sa -0
-tPROP,ERTYOWNMBYCL'AIMANTIK OTHER- COWNTIES
County Toomship
County Township
I hereby certify the above statements are true. correct and complete.
Siqpature of 1yeimam
V Va! "a
®-e um erandstreet "Y' state,2jPcade)
UU u
`` 'l`'•,VALUE,' „T� x
°" ASSESSOR USE ONLY --
.T+3
Y ETRUE TAXW -'�
,nSSESSED VALUE
-
HOMESTEAD
� NON,RESfDENTIAL `
'fl. ro T-'L . ` ^-?: �_ " ± rf�.1
`` 'l`'•,VALUE,' „T� x
_AT 100% OF:TTV
r VALUE may%.
�„� �„� r VALUES
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
'" r• Jt�` s
Other land
(2)-
+- ?""?"4 -vs".
e
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
-,. R r of
2110
Residential Improvements or Annually
,`CRS
Assessed Mobile I Manufactured Home
Garage
(5)
;fly ;t
Other improvements
(6)
Total improvements (line 4 through line 6)
(T)
Total value (line 3 plus line -7)
(g)
I hereby certify the above is true, coned, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
TANDARD: DEDUCTION 'ALLOWANCEe "b "' "�.�y�"'�yg� ` (*�,q. 'Y?'
_ �r°• ver:£ u' �i i�a* 3s:: WaE3. i- "�- ?L.i�— _``i��,�=i'= L.'SLY�..
20 _ Pay 20 _
Lesser of 112 Homestead
Vf! aeon or 535.000 S
na a Fgydriar I Datgw':g