HomeMy WebLinkAboutHomestead_Meny (13)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
;te FOmn 5473 (117 / 5�M
P rscribed by the DepaNnent of Loral Govemrtreof Fessux+
IN.C7R/Ir77MJ.0 Cm :a. <rec evin Rv FIf.... ... N...'16..,�
%C, FORM YEAR
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— JAN U -L LUUI
CERTIRCATtt'Nl STATEMENT •—y�7 � /{
I Me) .. certi;;39atBA�tf� t cry of Mardi, 20_
I (We) occupied as our principal place of.esiderCpe a fclbwwg described rn_�i prop,„ for which a Hortvgstead ptP6 hoof 0KtWareby claimed:
) owned ❑ Are buying under contract
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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
ff huyag on mltract. Fee Simple awnees name — —
Renders office where contract is recorded Record number Page
,,. ,..._ -- .. r ., ,, , �- - . :. :•. + ,.....,`�.Y-- r.PROPERTY.DES
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County
Township
T 1
(ch: awTUIdP)
Parcel number
Legal .Ptim
Is the properly in question:
lJ 3 —00
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❑ Real proporty ❑ Mobile Home, (LC. 61.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre drat imondatdy
sumeamds that structure is used to produce inmmie. describe the use and portion
of the property utilized to q+adticv
Lard not exceeding I (one) acre imnedately
aG- iQ -3G- �CCO -coq
PROPMTY.OWNED. BY CLAIAMT EFOTHER COUNTIES
County Township
County
Township
I hereby certify the above statements ate true. correct and complete.
1e of rrrrarx
Wess (nurbar and shoat a4'. stain. ZIP code)
USE O
it TRUE�TAX z A
ASSESSED,VALUE +
+'HOMESTEAD ;
;NON�tESIDEl(iIAL
ASSESSOR U
rvr, VALUE. r
'ATr10M OF TTV '
'. VALUE. a
"VALUE
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a. f
f
Lard not exceeding I (one) acre imnedately
surrounding residential improvements.
Other land (
(2)
Tdtid land (Irm 1 phis fire 2) (
(3)
Residential' or Annually D
Dwelling (
(4)
Garage (
I -
- ". .
Assessed Mobile / Manufacl red Home I
($) l ,
I
t 1
1() I
20 _ Pay 20 . —_.
Lesser of 12 Honnes+xd
Valuation or 535.000
i
Date signed