HomeMy WebLinkAboutHomestead_McGloneCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION Hcto'
State Form 5473 (8614 -03) E
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for flllno wudnrlir
I (We) / certify that onon therisl d� o March, 20
v
I(We) occupied as r principal place of residence the following described real property for which a Homestead Pro" �edihisRidFd6�imed:
IZ�1' I (We) owned ❑ Are buying under contract GIB 50'
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.
r,` CONTRACT.! RECOROEOi :°r��"i.s`- R.n'"3.t%"�+i„''
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
'c a ^i`aiy�, ?��i— •9s`..= it sti :�#PROP.ERT.Y 1%scR(rT10N II
County
Trmnship
.Taring gjs(rlq (city, awn, township)
Parcel number / '
O
L dee/,gcd /�Q /o /n. Is the property in question:
PPM 1
0Q Y
Qom/ —'— 0.466 property ❑ Mobile Home(I.C. b f. 1 -7)
If portion of me 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
t hcee
of property utiiized to produce income.
._.___ __-
'�P,ROP,ERTY OWNED`BY CL-AIb1ANTe1N: OTHER' COUNTIES; s„ x- '`'::y- c.y'_,i,•re."3j",,,�._'�'
County T
Township C
County Township
I hereby certify the above statements are true, correct and complete. S
Sign 2i t Q
Address ( erand street, :
: state, ZIP cyQ0) -
-
Q
ASSESSED V' HOMESTEAD! ' -��RE WV
�- nYASSESSOR USE ONLY S.t -},(, i hp a y� - a' NONRESIDENTIAL' : i
_AT 100 %YOF .,pV/1LUE�°f 140m,UE
Land not exceeding 1 (one) acre immediately J ',-erg. t'
surrounding residential improvements. (1) ys
utv r�
yh }
Other land (2)
Total land (line 1 plus line 2) (3)
' .� a _ir
Dwelling (4) yMI' _ INNER
'Residential impmvements or Annually ^ -- - -
Assessed Mobile I Manufactured Home Garage ()
Other improvements (6) ���`r3
Trial improvements (line 4 through line 6) (7)
Total value (line 3 pits line 7) (8) -
I hereby certify the above is true, correct, and Signature of Assessor Date signed
complete.
VerifAng action - Signature of Auditor Date signed