HomeMy WebLinkAboutHomestead_Lambert (3)1prs ;;jt CERTIFICATION STATEMENT
FORM YEAR '
HC10
I (We) Uek or a certifyUt 9 1& My of March, 20
described real property for which a HoT'Ie�sleacl Poipaity�T Credit is here y claimed:
I (We) occupied as our principal place of residence X Mtheoll �Ilrinq
❑ 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 thaL-19441,c4wzlg 6W1ti§@Fider a contract.
CONTRACT
-RECORDED
Ubuying on contract. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
County
-PROPERTY - DESCRIPTION
CLAIM FOR HOMESTEAD PROPERTY TAX
Township
CREDIT/STANDARD DEDUCTION
Taxing district (city. town, townshAV I
I (7N
State Form 5473 (RS/ 10-01)
Legal des
Prescribed by the Department of Local Government Finance
ropert estion:
SZ
INSTRUCTIONS: See reverse side for filing instructions,
1prs ;;jt CERTIFICATION STATEMENT
FORM YEAR '
HC10
I (We) Uek or a certifyUt 9 1& My of March, 20
described real property for which a HoT'Ie�sleacl Poipaity�T Credit is here y claimed:
I (We) occupied as our principal place of residence X Mtheoll �Ilrinq
❑ 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 thaL-19441,c4wzlg 6W1ti§@Fider a contract.
CONTRACT
-RECORDED
Ubuying on contract. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
y'- ---g- - --�— ` -414dPERTY OWNED BY CLAIMANT IN OTHER-COLIkTIES'.,
-� - Ai�itf -V— - - — , -�% .."
County
-PROPERTY - DESCRIPTION
County
Township
ture laimant. 174
Taxing district (city. town, townshAV I
I (7N
Pa r
Legal des
AL—.
ropert estion:
SZ
Valuation or $6.000
I
11
NZ property ❑ Mobile Home (I.C. 6-1.1-7)
If any Portion of at immediately surrounds that stificture is used to produce income. describe the use and portion
of the property utilized to Produce income.
Date
Otherland
(2)
y'- ---g- - --�— ` -414dPERTY OWNED BY CLAIMANT IN OTHER-COLIkTIES'.,
-� - Ai�itf -V— - - — , -�% .."
County
Township
County Township
I hereby certify the above statements are true. correct and complete.
ture laimant. 174
and strA city, state t�,f code)
AT100% OF TTV-
_Jnumber
AL—.
SESSOR,USE ONLY r *'
-
•+-TAX
ASS.ESS E D VALUE
-HOMESTEA D
NON - RESIDENTIAL,"
0AS
A
VALUE.
"
AT100% OF TTV-
VALUE
AL—.
Land not exceeding I (one) acre immediately
Valuation or $6.000
I
surrounding residential improvements.
Date
Otherland
(2)
4 4:
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
f STANDARD.DEDUCTION ALLOWANCE
20 _ Pay 20
Lesser of It2 Homestead
Valuation or $6.000
I
Date
13