HomeMy WebLinkAboutHomestead_WadeCLAIM FOR HOMESTEAD PROPERTY TAX a 4_F#ORM YEAR
CREDIT /STANDARD DEDUCTION I' ` f State Form y th (De / rtme D y
Prescribed by the Department of Local Government Finance 4'I�Lf Irt{ f �.pi..il'I
INSTRUCTIONS: See reverse side for filing instructions.
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PER-n CATION STATEMENTw x?f � ,E" „ i)b�v�"z `t;5'.t..'
I (We) certHV that orrthe 7 st day of Mal 1
ad ' P. -�r�
I (We) octopi our principal place of residence the following described real property for which a HomesteadVP.xrppert y Tavc Gedit inhere. by- daimed:
❑ 1 (We) ❑ Are buying under contract
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.
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-a+. .Xc ?i %y ,' { _.r- =''Y :R'CONTRA J ".1;zµ _ lz".'iy
zaa� � �.- �tr�.. ... CT.'RECORDED'. �:-. _ r.s
If buying on cenbad, Fee Simple owner's name
Recordees office where contract is recorded Record number Page
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- _ O _ Y� D_. - ES CR .I _
RP, E RT
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N'a:.r „usr�Tr,;.
County
Township Taxi isl' ip)
Parcel nu her
Legal SCriptio
Is thfion: propeM title Homo ( /.C. 6-1.1 -7)
t
If any portion of the residential structure or the land not exceeding one (1) tha mediately surroundused to produce income, describe the use and portion
of the property utilized to produce income.
i jrVit ;4” iPROP. ERTY. 01NNED` �BY CtA1M ,4NT;I1J.'OTHER`CO(11JTIES3� `+ �� „i` t_.° >~s�".t
County
Township
County nship
I hereby certify the above statements are true, correct and complete.
ignatu o aimant /
Ad r s (number and street � , stale, ZIP code)
Signature of Auditor
t9, vy„`o` �•-- �^xrar"3's- :'° -ss« .sip `a°>Z?6
xASSESSOR�USE - NLYa -' u
r.E
4 TRUE TAXI
ASSESSED VALUE
HOMESTEAD
-�z.
NON REStDENT1AL
ea,VALUExt3.{
"�.. rd: . its/ t3S' 35!-.^ ,.:'.- ,..�,,.e'rVAL:UE.`�'t+x,'
�AT�100 %'OFTTV�,
i,�VALU
Land not exceeding 1 (one) acre immediately
lt)
''iN±?
surrounding residential improvements.
Other land
(2)
. , f: "z' ;L
Total land (One 1 plus line 2)
(3)
Dwelling
g
()'�
5°
4 r
Residential improvements or Annually
Assessed Mobile / Manufactured Home
Garage
()
x
Other improvements
(6)ftx,
Total improvements (line 4 through line 6)
(T )
Total value (line 3 pits line n
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
DARD: DEDUCTION °ALLOWANCE.''.r1' ?a'uk"
RW
20 _ Pay 20
Lesser of 112 Homestead
Valuation or M.D00
$
Signature of Auditor
Date signed