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HomeMy WebLinkAboutHomestead_DeweeseCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR CREDITISTANDARD DEDUCTION FILED HC10 State Form 5473 (R614-03) / Prescribed by the Department of Local Govemmem Finance INSTRUCTIONS: See reverse side for riling instructions. I (We) ,s3 certify that on the 1st day of March, 20AY6 I (We) occupied as our principal place of residence the following described real fl§Tdwftf 0 "Property Tax Credit is hereby claimed: 9 1 (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.hr ^'- Ict. C0NTRACT'RECORDEO If buying on contrail, Fee Simple owner's name Recorders office where contract is recorded t�... �> y°4f +•Yrd '`xg'�'.- e4`'.y.' r' 'PRO P,ERTY..DESCRIP,T10Nr County Township Taring district (city, town, township) T V1 Parcel number J//�� Legal descn'p(ion Is the property in question: W S9 S— Real props If any portion of the residential sW ctum or Ne land no xceeding one (1) acre Ihat imme Ltuty surrounds that structure is used t of the property utilized to produce income. r I 7 I a- •..a'�} -ate_ �_,j• - _ ___ _- _ .. --, :arsa,v.4= sy�A--- _..'�T rv4: P, ROFERTY_OWNED;BY CL'AIMANTIN. - OTHER "COUIJTIES r}` :fY`%N 'x. {ak q;a5i'y} '" p' ^7- `"s..'? County Township County Township I hereby certify the above statements are true, correct and complete. ig ture of claimant AT,100 %.OF TTV �.. Address (number and streef, city, state, ZIP ode) �. ©= 7 y N "r.}'' tASSESSOR USE ONLY +" -TRUE TAXY4�'t Y a ASSESSED VALUE n y HOMESTEAD'z '" NO_NESR)ENTU\L "�r'y f•�- ,'- -,,,,_.�i vVAI:U, AT,100 %.OF TTV �.. VALUES'az Y..}v�lf,s..._ =VALUE -'�' 1� Land not exceeding 1 (one) acre immediately surrounding residential improvements. IfB Otherland 2y` s ?� y ^act'r«:�iF, Total land (line 1 plus line 2) (3) Dwelling (4) Residential improvements or Annually FT Assessed Mobile / Manufactured Home Garage (5)t1 T rr`°ti Other improvements (6) ' -sW, ,<alaafy� Total improvements (line 4 through line 6) (7) Total value (line 3 pits line 7) (6) 1 hereby certify the above is true, correct, and Signature of Assessor Date signed complete. Verifying action - Signature of Auditor Date signed &M --- �`..-`.' : E ',Yu'i'T"rt/r'. ,'�v �T, - STANDARD' DEDUCTIONIAL' LOWANCE� MW 20 &JPay 20 0 7 Lesser of 1/2 Homestead Valuation or MOW 5 Signature of Auditor Date signed