HomeMy WebLinkAboutHomestead_BurrCLAIM FOR HOMESTEAD PROPERTY TAX 1 oRM—,
CREDIT/STANDARD DEDUCTION HC10
State ram 5473 (R715-
Prescribed by the Dope,"°" of Lem' Conenx,len Frrrarm (1} NOV 0 12006
INSTRUCnONS: See reverse side for filing ius&u Lions.
I (We) ° oerGfy =tfiuit on:itie- tsfday�airl-a�r>. 20_
I (We) occupied as au principal place of wowing described real property for which a Homestead Property Tax Credit is hereby claimed:
kQI (We) owned El Are buying under contract
Have a beneficial interest in the entity that is liable for the property nixes on the property and that owns the property or is Guying under a contract
- "(. :,::.
"� .•oy
a
"SCONTRACT:RC-CORDED.#I „!` :r,. a. S •y Fs 3�_rr y. ,RSy '_ 5`
If buyfg on msb Fee S froe owners reme
T ' d' ., to
. fownshp)
I hereby certrfy the above statements are true, correct and complete.
S� d dairnat
1°` VALUE��
Y•RES1DBiTU1L
Pa number
Ram deft oltim wlae mtract is recorded
the
Rend number
Page
• PROPERTY DESCRIPTION' : ,.
•, `: . -
C—ty
TwmsNp
T ' d' ., to
. fownshp)
I hereby certrfy the above statements are true, correct and complete.
S� d dairnat
1°` VALUE��
Y•RES1DBiTU1L
Pa number
Leg desr nptibn
the
Lard not exceeding 1 (one) acre immediately
Reel poieV Mobile Fore (LC. 61.1 -7)
H any portion of the residential abumue o the lad net one (1) arse Ova innedatety cvnoumft dud s6whire
is used to prodx:e irmne• desube ore rat+ and portion
dire piiDppeertly uAtilb ed to prod” itoo . '
Other lard
. t, ..: i•r .• .,:.. �.. •,, : PRGPERT,Y.OWNED BY CLAfIdANT
Oi OTHER COUNTIES tr's `. ,t<i ..: :'..o „* - .tir....'�• ::' .:..'d, '`'
County
TotvnsNp
County
Township
I hereby certrfy the above statements are true, correct and complete.
S� d dairnat
1°` VALUE��
Y•RES1DBiTU1L
(number and street Duty. afaa. ZIP coo?) 1f It
�.YA.L..:i5..i.lt
- ASSESSOR USE ONLY 5 Y
� rTRUE TAX
20 _ Pay 20 _
`� a£i
fX
..... -. r
AT OF TTV
1°` VALUE��
Y•RES1DBiTU1L
..:!s . "i! 5MF • \ =1 It *4v U.)
�.YA.L..:i5..i.lt
Date sipped
Lard not exceeding 1 (one) acre immediately
surrounding g residential improvements.
Other lard
(2)
TMaf land (lie 1 PIUS Ere 2)
(3)
3 �g'?•...f$ i.. Tryf
Residential bnprovernefits or Annually
Dwe 6ng
(4)
Assessed Mobile I Manufactured Home
Garage
(5)
'.'p Li4�tr.,'r's Ff '^ l•At"Sin >r
�rf svf.., #GeNn(ua,r�Y.tr- �,riat'�� .
A� r ..
~- �
Other bmpimements
(6)
-7%
Tdal improvements (Ere 4 through fine 6)
m
TiJbl value (lie 3 pis fine 7)
(g)
1 hereby car* the above is true. correct, and
Siprrattae of Assessor
Date sgred
Vaifying adlcn - Sgnabare of Mndtor
Data sigrsed
®'
T i=�n3..g!`l3 STANDARD DEDUCTION ALLOWANCE ,+ ;• ...•;n :� ;e!i!tiw :F' -St§
20 _ Pay 20 _
Lesser of 12 Homestead
$
Valuation or 535,000
Signet" of Ammer
Date sipped