HomeMy WebLinkAboutHomestead_ShattoCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Slate Form 5473 (11614-03)
Prescribed by the Department of Loral Govemment Fm noe
INSTRUCTIONS: See reveASS ddb bQ6p 6nbuchone.
ff YEAR
I >�
NOV 0 7 2005
I Mre) certiryh�`G�fdstidMgt
I (We) occupied as our principal place of resi 6nce the following described real property for which a Homestead Property Tax Credit is hereby claimed:
KfI (We) owned ❑ Are buying under contract
Ph 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.
�CONTRACTRECORDEDs
.
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
'SkKa•:'.i' FY' ..e''S •�_`+S* s= ' PROP.ER1Y, OWNED !BY,CLAIMANT:IWdTHER'000NTIEST'
County
County
kwHOMESTEAD�'
"
Township
Taring (c" , toyn, township
.pyALUE�-
-r.?s:
ignature of I ' ant
L s n
�� /'��
Is the pro rty'
question:
11)
Date signed
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9' <'°,.i•.,* �`s-
Real property ❑ Mobile Homo ( /.C. 6- 1.1 -7)
If any portion of Ne resitlential sWcture or the d not exceeding one (1) acre that immediat surrounds that Cure is used to produce income, describe the use and portion
of the property utilized to produce income. D n
'SkKa•:'.i' FY' ..e''S •�_`+S* s= ' PROP.ER1Y, OWNED !BY,CLAIMANT:IWdTHER'000NTIEST'
County
Township
kwHOMESTEAD�'
"
County Township
I hereby certify the above statements are true, correct and complete.
.pyALUE�-
-r.?s:
ignature of I ' ant
Address (number and street, city, state, ZIP code)
•�. ( BOk )2 -82 Pafekq�Spl.
(f7Gt,[a
b.`'�ra1 � •c..
��^vASSESSORIUSE ONLY
r > TRUE TAXr
Q>:.e�' ;'J'.1
ASSESSED VALUE
kwHOMESTEAD�'
"
'NON- RESIDENTU\L 3
�R Si�FY'.
r'��`'i°yj
.pyALUE�-
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n° 1T 100 %_'OFTTV
. -,..,.
VALUE
i!3P {•...
.G �- VALUE
Land not exceeding 1 (one) acre immediately
11)
Date signed
�'="',jr
9' <'°,.i•.,* �`s-
surrounding residential improvements.
- . .�,.',
Other land
(2)
"rs`` =7�1
.IM-
Total land (line I plus line 2)
(3)
Dwelling
(4)
A 1 rr° r3EUA* -
'Residential Improvements or Annually
-+,`
Assessed M01389 I Manufactured Home
Garage
9
5
()
',_' MISS w ,i.'
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(g)
1 hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
' s ' �'a�2... •.
21��jf Q 2tp STANDARD: .DEDUCTION ALLOWANCE +p
20_Pay 20_
Lesser of V2 Homestead
vauamn or (35.000
Signature of Auditor
Date signed