Homestead_Wright7
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (Re / 4-03)
Prescribed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
I (We) certify that on the 1st day of March, 20_
2 I (We pled as our princip lace of residence the fol 'ng described real property for which a Homestead Property Tax Credit is hereby claimed:
I (We) owned ❑ 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.
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
PFtOP,ERT.I'- DESCRIPT101i •�kl':'?.k. �" ?:`. ?: 7',` -� + „ �; �. � j'.
County
Tovnship
Taxing di city, p tow iP)
mbar O -r�lj�
O �� (U v
Legal description Is the property in qu ti n:
21 eal property ❑ Mobile Home ( /.C. 6-1.1.7)
If any portion of the residentlal structure or the land not exceeding one (1) sore that immediately surrounds that structure is used to produce income. describe the use and portion
of the property utilized to produce income.
�}' �P- ROP. ERTYiOWNEDrBY: CI 'AIMANT'INiOTHER"COUNTIES'M"r ��i_r�+;,i��Kf ?.ly�°�?ir. "':7;
County
County Township
hereby certify the above statements are true, correct and complete.
Signatu of claimant
rasa (number and street city, state, ZIP code) LI
41-e OaAll-At
TRUE%?
'��`ASSES�SEDYALUE
HOMESTEAD
per,'- �'VstNON tEStDENTIAL ;
_ x: r' 7S�s.ra!F..2]x> +d.it�
ACIJE
,, AT100°6.OF'Ta7Y^
c�r�ry`- VALUE[
�3'(`I.;,;Y/1LUE.
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
M�:5y`t's
it
Total land (fine 1 plus line 2)
(3) -
Dwelling
(4)
'' " " },-!e' c
Residential Improvements or Annually
° "- "vrkt?ti��
Assessed MobFb / Manufactured Herne
Garage
(6)
��,`•",•�����tv"�? "^�_
Other improvements
(6)
Trial improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
"'OirKl i ?�3t'� 1--.±i — . —,3.., STANDARD DEDUCTION'AL'COWAWCE x` :ate .,J_x:.:.a � " .'ice >�c rr- 5` •r'` - -•
20 _ Pay 20
Lesser of 1/2 Homestead $
Valuation or 535.000
Signature of /wddor Date signed