HomeMy WebLinkAboutHomestead_HarpenauCLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT /STANDARD DEDUCTION .0
Stats Fonn 5 SITS (R7 / i t j
Prescribed the t of Local Gooerrxrnard Fsarwe
INSTRUCTIONS: See reverse side for filing instructions. FFB
CERTIFICATION STATENEMT::'
1 (We) 1 G/ - thM[cnlhe day of March, ZO_
I (We) occupied our prtrtdpal ence the fo8owirg described r property for which a Florrfes / Cl "T�t is hereby chimed:
I (VJe) owned ❑ Pre buying under contract )' AUOITO
Have a beneficial interest n the entity that is liable for the property taxes on the and that owns the R
properly properly a is buying under a contact
CONTRACT RECORDED,,. ; ..' . 'hi�i?.r rt. �' , �.i.':. *, T :.... " 11,".C. 3A
If buying on ..b Pee Simple owners name
ftnconWs office where mnbad is recorded Pwcord number Page
- •-
,i PROPERTYOESCRIPTION.,: • :,,. <;i( :f / t . ?t* [� ";ra ,y`f,*
Canty
Township
Taxing; disuit (rly fawn. township)
Parcel amber
Lnd Ion
(nwdw and street W sfate, ZIP code)
le the properly in question:
;, , �:,
property ❑ Mobile Home (1C. 61.1 -7)
If any patios of the residential struchsa or the h4M m¢eedng one (1) acre that inrtedta/ely surrounds that struchse is used to prodx:e income, describe the use and potion
of the property utilized to produce ixeme.
Ladd not exceeding 1 (one) acre iffnledatelY
alt -a3 -off- goo -coo. 779-CO�
;. =: .'.'PROPERTY OWNED BY CLADiANTd OTHER COUNTIES+ `'`
County
Township
County
Township
I hereby oertify the above slatenrnts are true, carted and cofplete.
Sij natum of damwd
(nwdw and street W sfate, ZIP code)
i.:
TRUE TAX
ASSESSED VALUE
HONEZTEAD
CiyNON tESIDEN71Al` h,�tTt'�3'.
NLY :.' .
ASSESSOR USE OAT
p``
? V/LLUE;
100X
;, , �:,
Ladd not exceeding 1 (one) acre iffnledatelY
i,r
ki`iY'
surrounding residential anpmVernents.
(1)
i, ! ;�SiySjti N�'•u?;,C. Y._i.N SA`l
`'
Other lard
(2)
: K .,. ;. { ; ?F
Tdaf (and (lore 1 plus fore 2)
(3)
Fes, r
N``
Residential trnprvvernents or Annually
Dwelling
(4)
- x s r='.x�� 'i s Lp.;S `'.°• r':(
Assessed Mobile If Manufactured red Herne
Garage
( 5 )
' Y y y9 1. lv"e
� a K
Other improver ents
(6)
Total trnpromnants (fie 4 dvough One 6)
(T)
Tdal value (fore 3 pots fire n
(6)
1 hereby car* the above m true, cored, and
signabsa OfASSSSmr
Data signed
complete.
Vailying action - SWwture of Audmr
Data signed
t ' , STANDAIm DEDUCTION ALLOWANCE a a Y ':z! s" n > '� 1 11' .'
20_Pay2o_
Lesser of M Homestead
$
Valuation or $35.000
Sgiahme of Auditor
Date signed