HomeMy WebLinkAboutHomestead_Lloyd (2)} CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Forth 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (we) v- certify that on the 1 st day of March, 20
I We occu ' as our principal place of resi nce the following described real o erty for which a Homestead Property Tax Credit is hereby claimed:
I (We) ed ❑ 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 property or is buying under a contract.
F1 L O 0 YEAR
OCT 2 7 2003
..��,' =t: ," {`'i"•-F ,&yy =.,+>s fr- ? 'r' ''aFT' i`. �CONTRIiCT:RECORDED -c -,'�! siw-_ `�.'�!Md-- -14iz, '
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
_�•i's��s�~-..- „�css�'?�' ��aPROP.ERTY;OWNED BY CIAIMANT;IN OTHER` COUNTIES -�1$ty`r„:�?.�L,��;?i��`s'
County Township
.i--s P,ROPERT,Y..DESCRIP,T N!-• t' ri?' ;- "+e`,;fias f._
County
Township
Address (number and sheet, city, state, ZIP code)
-P-0,06-)(13 4 oe r1/
T g tu (city to township /
/ 5
;VALUE''
,} V LIE a
Land not exceeding 1 (one) acre immediately
P I
Legal description
Is the property in uestion:
Tnoer Jr
v
eat Dmperry ❑ Mobile Homo (l.C. 6- 1.1 -7)
H any portion of the residential structure Or the land not exceeding one (1) acre that immediately surrounds that sWcture Is used to produce income, describe the use and portion
Of the property utilized to produce income.
(2).,`
/ dyj i
_�•i's��s�~-..- „�css�'?�' ��aPROP.ERTY;OWNED BY CIAIMANT;IN OTHER` COUNTIES -�1$ty`r„:�?.�L,��;?i��`s'
County Township
County Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant
Address (number and sheet, city, state, ZIP code)
-P-0,06-)(13 4 oe r1/
yi�w ° 3 A55E.SSOR SE ON Y A -W
-TRUE iru
ASSESSEDNALUE
iHOMESTE t�`
i
I9 eNON'- RESIDENTIAL ti' s
'}`�”
_ .-�- ,ffi
ZKVALUE
ATk100 %,OF�'TfV
;VALUE''
,} V LIE a
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2).,`
Total land (line 1 plus line 2)
(3)
Dwelling
(4
� 4
�
Residential Improvements or Annually
Assessed Mobile / Manufactured Home
Garage
(5),/,�
'h
Other improvements
(6)'a
rr _�
Total improvements (line 4 through line 6)
(T)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
V-
®T�* ". v�r„�,:;� ':�` _ ,z ; � _.',`STANDARD: DEDUCTION `AL'COWANCE,S�e":;;i,r'
s 20 _ Pay 20 _
Lesser of 112 Homestead Ts
-
Valuaroon or 535.000
Signature ofAuditor Date signed