HomeMy WebLinkAboutHomestead_EatonCLAIM FOR HOMESTEAD PROPERTY TAX
CREDMSTANDARD DEDUCTION
State Form 5473 (R7 I 54M
Prescribed by to Department at Local Government Finance
INSTRUCTIONS., See reverse side for filing instructions.
FORM
HC10
I (We) --I " /It/ 17 (' 'Q zer:n- � certify that on the 1 at day of March, 20
1 (We) occupied as �& principal place of residence the followng described real property for hih a Homestead RoI41ii,��ill hereby cfai�.
L/ AUDITOR
❑ Are buying under contract GIBSO'l COUNTY
eve 67=021 interest in the entity, that is liable for the property taxes on the property and that owns the prop" or is buying under a contract,
C ONTRACT, RECbRDED -, -* i
_4�
H buying an ccatnic', Fee Simple owners name
Remxdeft eflice Wheat =0 cl is recorded Record number Page
TawraNp
parcel rxffnbw agal description ft
H any portion of ft residential struclura w the lend rid exceeding one (1) if.- that immedudety suffounda
of the property utillized In produce income.
in � question:
LR� WW"
❑ Mobile Home (IC. 57.1 -7)
tm
is used to procklos income, descrilpe ft use and portion
'�r
�Vf(.NN PROPERTKOWNE6
County
Township
County Township
I hereby certify the above statements are true, correct and comp4ate.
Or(number aid stmet crli4 state, ZIP code)
Z mmwym-
2q�J /Pay
Lesser of W Homestead
Valuation or S.0D0 $
535.000
f
Signature of nil 9�14 15, Date signed
ct�j,TRU E iTAX?AO'll 4,
ASSESSEDNALUE
-1�14OMESTEADW
��`NONAESIDENy";U'
T 0
VALUE
Za
Y6-t-
Land not exceeding 1 (one) acre immediately
W,
4WMX W�'
mum
surmunding residential improvements.
04
Other land
(2)
' 'f:"OR
knit M
TcLW land (fine I phis 579 2)
(3)
Dwelling
(4)
1V1�1WP1WV'V6M- I'
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
r
(5)
f4,` -.''(. All.
Other improvements
(6)
—;w
Tdal improvements (fine 4 through line 6)
(7)
Taal value (fine 3 plus fine 7)
(8)
I hereby certify the above is true, comect, and
Signauma of Assessor
Data signed
complete.
Verifying action - Signatre of Auffitx
Date signed
Z mmwym-
2q�J /Pay
Lesser of W Homestead
Valuation or S.0D0 $
535.000
f
Signature of nil 9�14 15, Date signed