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Homestead_Bashaman CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR CREDIT/STANDARD DEDUCTION State Form 5473 (8715.06) Prescribed by the Department of Local (33overrunerd Finance INSTRUCTIONS., See reverse side for filing instructions. I (We) 'i'T :��AaAxtzyy%-' certify that on I 'n�!L place of residence, the following described real prop" for which a Homestead Property I (We) ticcuyed I ❑ l(We)owned ❑ Are buying under contract JUN 2 9 2007 ,r&Ha.e 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 cowiRiwrmmommy,03�' W-V � *�MM ff buying on ..b Fee Sirriple owners narns, Recordeft afka here contrad is recorded Record number Page V4UfMZ-'WrA91; 1$11 .i�PROPERTYOWNED;BY-CiWMANTENOTHER-COUN7nE�6"�M4�'Zg�t-�l�V %)':V1QW.VPA Mil PROPERTYMEWRI&IO Colff dy Tiawriship Tivang district (city, to". towns*) �Parcel ,!wjj . q-1CO.Mg.,�q Legal desciption Inal is the property in question: I ❑ Read property ❑WWI, Home (CC. 61.1 -7) N airy =rftb2=Wd=.Z the lard not exceeding one (1) tons, that immediately surrounds that stricture is used to produce incerne, describe the use and portion of the V4UfMZ-'WrA91; 1$11 .i�PROPERTYOWNED;BY-CiWMANTENOTHER-COUN7nE�6"�M4�'Zg�t-�l�V %)':V1QW.VPA County I Township County Township 1 by oer ?a abAve a, correct and complete. j . MIA Zaaretru Signature of cLairnarg Address (nurriber arid stimut city. sta ALM W Li4Q(- 0 S ,tASSESSEDNALUE V. ,,��HOMFSTEAWWY: �f N ID T1 IT No AES FS .. ........ . Lesser of 1R Homestead Land not exceeding 1 (one) acne immediately, Valuation or $35,000 $ �0 _Q;YWA surrounding residential improvements. Date ad Other land (2) rte Tcted land (fine I plus [no 2) (3) Dwelli rig (4) gi Z � Residential improvements or Annually 5001"M§ ar Assessed Mobile I Manufactured! Home Garage gp (5) Other improvements (6) Tdal improvements (rme 4 through fine 6) (7) Toted value (fine 3 phus &* 7) (8) 1 hereby certify the above is true, correct, and Signature of i1seessair Date signed complete. Von" action - Signature at Auditor Date signed 20 _ Pay 20 Lesser of 1R Homestead Valuation or $35,000 $ Signature of Auditor M aAA ka'L-� Date ad