HomeMy WebLinkAboutHomestead_BradshawCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION Hcia
State Form 5473 (R6 / 4 -03)
Prescribed by the Department of Lord Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
STATEMENTi _
I (We) yeA#7ttha2 J dM day of March, 20
(We) occupied as our principal place of residence the following described real property for which a Homesteja�' Property Tax Credit is hereby claimed
❑ I(We)owned ❑ Are buying under contract����yy����(�(,,
Have a beneficial interest in the entity that is liable for the property taxes on the property alWjftA br. rAoDyjQgymder a contract.
aCONTRAC_T!RECORDEDt,' e�'xt.Y �r.:'��.� -:�' '.i'�k.�'iF Ft �r'�2'7•s"'i� t - { ='
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
',�.xc'r:�c: ;v�:HS "= - tK`...?P. ROPERT .Y,DESCRIPTIONr..l`??t3G'pa-a
County
Township
Taring district (city, town, township)
P c91 prmbe
114 l! VD
I description
Is the property in question:
❑ Roal property ❑ Mobile Homo (I.C. 61.1 -7)
If any portion of the residential armature or the land not exceeding one (1) acre that i
of the property utilized to produce income.
diatel surrounds that structure is used to produce income, describe the use and portion
J2.. �"4?}j e _.. . . _ .. 4.i Tic' 'g.
�.,a... -.. '�. .- � �.A".€��P,ROP,ERTY: OWNED! tiYCL'' AIMANT ;IN�:OTHER'COUNTIES ;�c�;-b „'±��. ��..".�,�+�xy^:h
County
Township
HOMESTEAD7'+
County Township
hereby certify the above statements are We, correct and complete.
;VALUE rte.
Signature of claimant
Id[Ass (number street, r
,stare, ZIP e
?6
y,) ' ` •ASSESSOR t1SE ONLY `
�"TRUETAX* --
ASSESSED VALUE
HOMESTEAD7'+
rr� NO ESIDENTIAL
;VALUE rte.
"AT 100% OFmTTV
_ VALUE��, '',
lu&X0 M.VALUENTP��
Land not exceeding 1 (one) acre immediatelyY
lr�, •�y+,g"' - +Y6i(
surrounding residential improvements
Other land
(2)
Total land (line 1 plus line 2)
(3)
(Residential
Dwelling
(4)
rX,�c �v'Tv+.rK
�"�'� rK
improvements or Annually
-1
#�'
Assessed Mobile/ Manufactured Home
Garage
5
_
� it � t1- ti?f
Other improvements
(S)
Total improvements (line 4 through line 5)
(T)
Total value (line 3 pits line n
(S)
I hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
.5STANDAWMEDUCTION'ALLOWANCE x
20 _ Pay 20
Lesser of 112 Homestead
valuation or 535.000
IS
Signature of Auddw Date signed