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, CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
State Form SG73 (RB / 4-03)
Prescribed by the Departmeni ot Local Govemment Finance
INSTRUCTIONS: See reverse side /or /iling fnstmcfians.
FORM YEAR
�Kin��� 1�
11J
MAY 5 �ona
� M'ei � � L ce�dity-iha�mntlr z1,slU�3y<of.Matrh� 20
i.� �.�.c.,. � ,:'�. . i.-,. i —
I(We) occ as our principal place of residence the foliowing descnbed real pmperty for which a Homestead Property�T�c�CrediP�i's A'e2tiy daimed
�I (VJe wned ❑ Are buying under coniract
Have a benefidal 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.
If buying on conUad, Fee Simple owners name
ofim where wntrad is recorded
Counry
7o.mship
townshiP)
Rewrd number � Page
lYCld �O /��O'O �(!�I / / �yl�tJ O//�� �/ �I"Y'av'�eaID�QPpKY ❑ MobileHOme(/C 61.f-n
If any portion to�lhe resitlmtial sWClure a Ne land no� exceetling one (1) a tnat immediatety sunounds Uat swaure is used lo produce incoma, desaibe the use anC portion
o( Ne proparty utilized In produce income.
. i�a ��
CauNy
= 3/- .3a� - a��3SS- a �/
- - ---- - - - _ _ - --
�� "`PROP.ERTf`OWNED�BY'CL''AIMANTIN;OTHEf
wn5hip County
I hereby certify the a6ove statements are W e, conecl and complete.
(num6er and sUee(, ciy, sfale, ZIP cade)
of
� - +'ASS � USE ONLY��,��-j�� �UETAX��,�. riA,SBESSED VALUE ��H�OMESTEA� _ 3 }N N RESfDENTIAL �=?
. ro � .�• 6 VALUE AT,E700�.OFTiV VALUE -..-VALUE�x�,�+'�-�
^•-i� � �F6*.="�'�'£�....� 3i�_ .�. -'�`'`- :> `.,,3.�. � 3s�4 .,,...,r .Tt.s....�
Land not exceeding 1(one) acre immediatety ,� s� ''���"'�1 `���"�',�€q
9 P ��_t ' :'�e.�y,���.�'.
surroundin residentialim rovemenis. (�) •_ ,�t.������r
�� i3�_ �y� _b .
Ofher land p �'+a '�� • �'
( ) x�-�-- -
��: _
Tdal land (line 1 plus line 2) �3�
Dwelling (4 "�'���������' ��� �°�
ResidentialimprovementsorMnuaOy ) ���`��.�� .-.�
0.ssessed Mobile I ManuFac4ued Home Gara e ���"o- S�� `^-.;�•�`c'
9 �5) �`��.:�,•��'s"�s .. �=�'�'_�����.�!
�,-.�sJ��
Other improvements (6) �-u _` �" .n,��.�,
?„=?�'�i�?r::�'�r •
Tcial improvements (line 4 through line 6) (7�
Tolai value (line 3 phs line n (g�
I hereby certi(y �he abOVe i5 We, corred, and SignaNre of Assessor Date signed
complete.
Vaif�ring action - SignaWre oflwditor Date sgnetl
��`F"%�. ����3''��''�i....'-'� e�s;3'_��`'��"STANDAR�;DEDUCTIONALLOWANCE��:�'�.T''�-��`.'t, .. ��:'���.,:.'�-��.:.t'�'..�J�2"��r�
20_Pay20_
Lesser of 1/2 Homestead S
vaivaLOn or E35.000
Signature of Audilor � Date signed