Homestead_Benson (2)CLAIM FOR HOMESTEAD PROPERTY TAX
t CREDIT /STANDARD DEDUCTION
` Slate Form 5473 (8817 -07)
Prescribed by the Department of Loral Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
K
kYEAR
JUN I 0 2009
I (We) ..ej7_W,o-r lJ certifyitPWBtnCr}@(>"y 9 March, 20
I (We) occupied as our principa ace of residence the following described real property for which a Homestead Property Tax Creditil claimed:
I (We) owned ❑ Are buying under contract
1: 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.
CONTRACT • . .
If buying on contract Fee Simple owners name
Recorders office where contract is recorded Record number Page
AS SESSOR USE ONLY
1ASSESiEDVALUE1
TRUE TAX VALUE
HOMESTEAD 1
PROPERTY
County
TornshlP
T " g district (city, town, township)
afyLf
Parcel number
LegA desc'ption
''Jp
« % -
Is the property in question:
Real property ❑ Mobile Home (IC 61.1.7)
Harry portion of the residential stricture or the [and not exceeding one (1) acre that immediately surrounds that stnuture is used b produce Income, describe the use and portion
of the property utilized to produce income. -
a� -�� -aq -ate -�� Quo - oa/ &.75.
AS SESSOR USE ONLY
1ASSESiEDVALUE1
TRUE TAX VALUE
HOMESTEAD 1
NON-RESIDENTIAL
AT 100% OF TTV
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
- ` �` -r•"' �*` x ��-r 'Y'
surrounding residential improvements.
Other land
(2)
Tdal land (lime 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
....�.:o rl.-��> -e.., :��:•��- = =:c --
Assessed Motile I Manufactured Home
Garage
(5)
Other improvements
(6)
-
Tdal improvements (line 4 through fine 6)
(7)
Total value (line 3 plus fine 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed (month. day, year)
complete.
Verifying action - Signature of Auditor
Data signed (month, day, year)
STANDARD s r
-� pay 20 — 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestete ad d Valuation §
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor Date signed (month, day, year)
__________________ __ ______ .__.____________________-______ _________-- ______.___---- -____. 4 W_ ----- 1r__'__ I--� _____________