Homestead_ZasadnyCLAIM FOR HOMESTEAD PROPERTY TAX
CREWTISTANDARD DEDUCTION
State Foos 5473 (R7 I 50b)
Prasorbed by the Deparbriard of Loml Govenirnant Finance
INSTRUCTIONS: See reverse side for tHmg instruciJons
coo I
AUG 1 5 2007
I (we) A 611,&64-V C 1j0AI'll'4Z
I (We) occupied as our principal place of residence thfilkivivig described real property for which a Horriestead Property Tax Credit is hereby claimed:
I (Vie) 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.
C0NTRACT,RM0RDED; .4,
W,
If buying on m b Fee Smos owners n,arne •
Rocmnjees afka where contiact is recd, Record number Page
FiRdparrybmcmirnm-
al"
County
Tawlship
County
Township
I hereby certify the above statements are true, corred and complete-
signature of...
'!,VALUE
Signature of Auditor
Parcel narba
Lao description
Is the iirop:
qmsfion
/97 5, /,M/A) 5r 62,q),c[11A)V
I
Real Rap" MoWs Horne (I.C. 6-1.1-n
If m�of ft resdential shicture m the land not mmesding one (1) acre that emisdalmly mirmundil that sfinkhRe
m used to pro&= incorre. descrit)e the utie and portion
Ld,5md W pMd" mr,001nfl.
zlld 9 L fa 17 /a � - 6 =I -Pai Q '17
'07 N ER COU N T1 ES
al"
County
Tairnship
County
Township
I hereby certify the above statements are true, corred and complete-
signature of...
'!,VALUE
Signature of Auditor
f,
umber and atrmt, o1j,; staiiii ZIP Code)
/97 5, /,M/A) 5r 62,q),c[11A)V
c17-� I-W-4-76,gz
ASSESSM USE ONLY
20— Pay 20_
'ASSkSSEb,4ALL&
Lesser of 12 Homestead
NNON
t, VALUE
�-ATAODWDF TN
'!,VALUE
Signature of Auditor
Dele signed
Land not exceeding 1 (one) acre inirnectiately
(1)
surrounding residential improvements.
Other land
(2)
t: A,
Tcted land (line I ptus firie 2)
(3)
Dwelling
(4)
Residential ffnpraoin. ents; or Annually
Assessed Manufactured Hum
Garage
(5)
Other improvements
(6)
Total irnpravernerds (fine 4 through Ine 6)
(7)
Total value (fine 3 pots fie 7)
(8)
1 hereby certify the above is true, correct and
Signature af Asaasscr
Date signed
cornPlete.
Veffying action - Sigi ohs u of Auchx
Date signed
STANDARD DEDUCTION ALLOWANcE,,
20— Pay 20_
Lesser of 12 Homestead
Valuation or 535,000
Signature of Auditor
Dele signed