HomeMy WebLinkAboutHomestead_Stuckey (2) f
frift ts CLAIM FOR HOMESTEAD PROPERTY TAX �O FORM - YEAR
CREDIT/STANDARD DEDUCTION HC10
Stale Form 5773(R6/4-03) -
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Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
3Y.",•i -Mp'°1, i'LV IC44:,y; .siW, a ,- `- .OERTIF.ICATION STATEMENtr iii T k:.W _';; . :WW551, r r,,.;`
I(We) L r se 1 (r - /-- /• certify that on the 1st day of March,20_
I(We)occupied as our principal .- of residence the following described real property foil ich a Homestead Property Tax Credit is hereby daimed: ,
❑ I(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 thelp property or is buying under a contract.
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s''>.As. -�f.. ','.:.,.�,.... '=-r?`z<•.:. - t..i�'FP'^Ar/�..kas'.,�. e'',n'.. `�,a.CONTRACT.'RECORDED!a.�"iae'� +x "��?�3'r"'f•-�"�SWi'�.'�"N-�`."-�'.'F':<+ri'
If buying on contract,Fee Simple owners name SEP 0 8 'tun
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Recorders office where contract is recorded ///' _L Recer ffnumber Page
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.4I.1,W �.'x�iti'ic<-kr; =_>r, �-I^, t � .:P,ROP,ERTY.DESCRIPTIONn: 1'a- .,s=- �4s:+ ``' =.i. ,cf 'E+'.4,'as_;- :
/ 7� Taung tlis 1rJry,fawn.township/
1. cel number Legal description Is the property in question:
00G - 00
a Real property ❑ Mobile Homo(LC.6-1-1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
agy„i+ini.,,,.,r$143ROP.ERTY;OWNEDBYCLAIMANT.I14'OTHER'000NTIESaaa y"�.rte ida�.';rf•1<-
County Township County Township
I hereby certify the above statements are true,correct and complete. YSignawre of di
'dress(number and street,city,state,ZIP code) /�)
3t LCISA:no,tr'1.Z i'. Sr•MCrl7r lie_ yi✓ 4176 A5
mo t'=# A ESSD ar-AY ,: f r'TRUEArst ASSESSEDYALUE HOMESTEAD. NON-RESIDENTIAL S is
• fi, __ g.. m.rav -,-.3i_�.+2t :G".,,-< tvALUE n, , ATz10oYaOFrTfV4 h rVALUE m r` ` V/LL--.4. -<,
Land not exceeding 1 (one)acre immediately (1) 4lfir's`� ,��3 is
surrounding residential improvements. l' - r1iY„--='r. ,,V
( ) a a
Other land 2
Trial land(line 1 plus line 2) (3)
wit; /- cya,-r, f. 9'
Dwelling (4) W" �ai
Residential improvements or Annually _.
Assessed Mobile/Manufactured Home Garage (5) - �s S:4 r`E
T = 4
Other improvements (6) €� �'
Tctal improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is r - correct,and Signature of Assessor Date signed
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complete. /^/
Verifying action-Signature of-1• Date signed
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,,, .,` ,�'-•--''cv . . ju; „TANDARE,!DEDUCTIONAL'COWANCE •c '" ...„). ' ,r? i v,"; "- ..
20_Pay 20
Lesser of 1/2 Homestead
nation or$35.000
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Signature of Auditor / / , Date signed
II
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Forth 6173 (R614-03)
Prescribed by the DaImIment of Lnnal Government Ftnaros
INSTRUCTIONS: See love= aide brl®rrp kaftcdau.
FORM YEAR
HC10
I (We) certify that AV TV" lrNfarch, 20
1 (We) occupied as our principal pl ce of residence the following described real grope or which a Homestead Property Tax Credit entry claimed:
❑ I (We) owned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the ro�ppe ✓ ✓rty rtr i,�� uying glider a contract.
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.���- �..x -sfr. ..- :,.. •yE:�: �, ^".•�2CONTRACT-RECORDED i7a- - T�j':.�p(rsy,at-• ---.x_ .x$:� ..� y� "-= l�,(.,
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
a>w FV1 - ?'mot- '� _ rw -M 7'a z �PT "-
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County
Township
Testing district (d town, township)
Pa RA( n0f4mv �O
V h/•1 -�J
of description
Is the property in question:
Weal property ❑ Mobile Homo (I.C. 67.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately s me cods that s Cure is used to produce income, describe the use and portion
of the property utilized to produce income.
s - _
rW: Z-W � - ..,i'"s - _�"1. -�., PROP.ERTY,OWNruisY CL''AIMANi;IN OTHERCOUNTIi 94!..", -+w
County Township
County Township
1 hereby certify the above statements are true, correct and complete.
Lure or claimant
• 1dress (number and street, city, stale, ZIP code J ,7
l CX 7
VALUE
:SAT 100 %OF�TTV
i'TRUETAX�'
.K
ASSESSEDVALUE
aw.
HOMESTEAD`
z NOON-- REStDEHTIALq;
,SSESSORUSEONLYIfl-
VALUE
:SAT 100 %OF�TTV
�'�VALUE�.VALUE{
-."�
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
V,r- -'
Total land (line 1 plus line 2)
(3)
Dwelling
(4)�
-j
Residential Improvements or Annually
AtlaetnedMob%I Manufactured Home
Garage
(5)s�
-_ sr��
;Az'
Other improvements
(6)
3�Y
Trial improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
hereby certify the above is true, coned, and
Signature of Assessor
Date signed
complete.
Vedfytng action - Signature of Auditor
Date signed
`;?sSw „ ,q 5STANDARD.DEDUCTION"ALLOWAHCE-
xYu.� y
20 _ Pay 20 _
Lesser of 112 Homestead $
Vauabon or $35.000
gn r of r Date si¢(pcy
STATE FORM 515691R:1]L9) TREASURER FORM TS-IA
APPROVED RESTATE BOARD OF ACCOUNTS.X09 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINAWR C6-I.I-_-S I
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
deduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead
• fraud causes higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the
homestead standard deduction to verify that they are eligible to receive the benefit and to provide
additional indentifying information necessary to allow county government to better monitor homestead
filings. This information will be kept confidential and can only be accessed by authorized county officials.
The Department of Local Government Finance will use this information to create tools that will help
county officials eliminate homestead fraud.
�fR PART l: PROPERTY INFORMATION
Address(number and street,city,state,and ZIP code)
State Parcel Number
L.(o - 3r - oa -' yD3 -bbZ). Ofa3 -CZ2�
PART 2:TAXPAYER INFORMATION
OMner I First Last
Mailing Ad. ess(number and street,city,state,and ZIP code)a W 5 • _1 . .�. ,6, . 4 e _'r,,y address
5 �.. . 1 • ,t —SAL r3 s 1 r • _ 4.1 —Cs
Spouse First Middle Last
_
Mailing Address(Number an city,state,and ZIP code) V Y Same as property address
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is
eligible to receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional
homestead deductions unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owne YS ature, 1 Date
PART 4:ADDITIONAL INFORMATION
•
INSTRUCTIONS
M v P Pv3a e- x ,/