Homestead_Robbins (2)i,� �� �.
CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD/SUPPLEMENTAL DEDUCTION
Stata Form 5473 (R12 / 6-09) .
Prewibed by Ne Department af Loml GovemmeM Frence
�IL
J�,N
ORM
HC10
2U
YEAR
INSTRUCTIONS: See reverse side for frGng insfructions "
.:,
. �
I(We) � certify Nat I(we) ocwpied as my (our) prindpal
place of residence or am (are) 6uying �he following des<xibed real property tor which a Homestead Property Tax Siandard Deduclion is hereby daimed
untler contract on the date this application is filed, (date of filiig):
❑ I(we) own ❑ Am (are) buying under recorded conVad
❑ Am (are) entiUed to occupy as a[enan45tockholder of a cooperalive housing corparatian
� Have a benefidal interest in ihe Wst or the right to occupy the property under ihe terms of a qualified personal residence Wst
.• • •
Recorders ofi�x where contrad is rewNeC � Remd number Page
._�. _ �
� Township T G� dty bwn,jpwnshi
IL
Parcel numbet Legal desaiption Is ihe ProMnY in W�tion:
� � al property � MnuaAy assessed rtaWe Mme (IC &7.7-�
�
11 arry portion W ihe �esMential swcwre a the IaM not exreeding me (t ) aae ihal hiune0iatey surtou Nat snucture is usetl m pmdux incana. desaibe the use aM pwtbn
esid
of Ne P�PertY unT¢ed lo produm incortre. _
-�• � �: • •
CouMy Tpvnship Counry TowRttup
I hereby cedify the above stetemenis are We, corred and complete. S�g`a 6� d'i`nan� ` .
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P4dress(numDerendsimet, afate,andLP ) ! I� �n /��
� � �v��-•e2`�i✓ PR.N�.� l �6
.- .
. . .. . ,
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Land nat e:ceeding 1(one) acre Immetliauly y-�`s._�S�a.� ^b`�`��'�?�'� �'�'�'°.
aunoundin residentialim rovements. ��) -�'�� . �``-�,�`� -�i5
y.�s:.f,-y�°.l. i ro,'
Olhet lantl (2) �� �� �_
7atal land (line 1 plusline 2) (3)
'�t- - �-v4 ySgyc^µ
ResidentlallmprovementsorAnnually �����9 �4) ��-0�'y�x,.���y.°''tr���
Assessed MobiM / Manufactured Hame F"'�.> r�Y. �`' "'��'�-t.�l:'�T��r�ik�`
Garage (s) re'�-�.s�'�"'i''���'k'm,.�.`s�#.�.#
x.�.^,-'T.' --'L._�.•Y?:='fi. .
Other improvements (6) ;k��i:r±.; ��
7atal improvemenb (line I Nmugh Ilne � (7)
Tofal value (llne 3 pllc line 7) (8)
I hereby certify the above is W e, correct, � 5igriawre oi Assessor . oate slgned (rtanM, day, yea�
and wmplet¢.
Veify�g action - 59nawre oflWdtor Date signM (marth. daY. YTa�
� . • � � � • �
20 _ pay 20 ' Lesser of 60% of the assessed value of the homestead or $45, WO
r�on.�nsram� a�y oure� wo�w�. me su�, o�ure eee�co�,s v�+� ic s�. r-�z ro e rronua rome ma� a g '
not ssressed as rael property oi to e menutdclured hwne Nat is not essessed as ieal propeM maY rot exreed
an H(12f W Ne assessed relua W Me rtpbde hame or manu7eUUred frorro.
�p�� Dete netl ( fh,�O]ay�, .y,Ea
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