Homestead_CornetteCLAIM FOR HOMESTEAD PROPERTY TAX
CREDMSTANDARD DEDUCTION
State form 5473 (R7 / 5-0M
Pmarnbed by true Depatrnent of Local Govemmap Fiance
certify that the 1 st day of Match, 20_
place of residence fhe foAowirg escnbed real property for which a Homestead Pro Tax Credit is hereby claimed:
I (We) owned V ❑ Are buying under contract
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;RECORDED,ti..;
if huy'vg m mri Fee Slrtple a~s name
RKordefa afka whets cw&W m rawded Retard number Pepe
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.:.i ; •Y "•�PROPERTY .DESCRIPTiON/--j t t1 �t ,ti s[.r:i - .:F :+•- Aiq;�'?
Canty
Township
Tomrhtp Tmrirg Nwrm, f ` )
Parcel
I hereby certify the above statements are true, coned and complete.
L
b property in
a
V
. ..
-
pope ft Mobile Home (LC. 61.1 -7)
If arty
of "the Structiae or are land mat exrse6ng (1) ane wnae� t� m used b proAwa is>orna. describe the use and potion
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of tthhe�/(J
u5f®d to pr immure.
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—CJC� � — el �
'6:''. 'PROPERTYOYY ED SYCLADIANTOI
OTHER COUNTWSrn..
County
Township
County
Township
I hereby certify the above statements are true, coned and complete.
m of
.,VALUE "x
a
V
(nwdw and street, alp, state. ZIPcode)
�a old . e4c n fr. sus lie ail, It 7eef
w
ASSESSOR USE ONLY a '
TRUE.TAX
ASSF.SSIcD VALUE
HOtlESTEAD -.
'c u NOWWS(DEI'ITIAL �
15 �.•<'P5'r` <,
i V/iLUEi :�, .,
,AT 100%OF
.,VALUE "x
�a ra,..i •s�'; VALUE t,.`Sa +fie;?- ,.,acv
Land not exceeding 1 (one) acre imrtnediafely
rh
surio mdi ng residential improvements.
(1)
i •:l a *r { � r r�.rmS }r t i s %vg!
Other land
(2)
;�t.'t -,j' `•.'.�:�
Total land (fate 1 plus Ere 2)
(3)
Dwelling
(4)
�afirrA
•'r,Fz t'�`Y�
Residential brprovetnents or Annualty
+, ` a -'rc' . "y' ..�.r -, a
Assessed Motge/ Manufactured Horne
' <x+'yir�ev.
r
C8f8g@
lf
Other improvements
(6)
Total "vrprovernerds (Are 4 through line M : `
'(7)
Tote) value (fore 3 plus lie 7)
(S)
I hereby certify the above is true, tarred, and
cor plete.
signature ofAssesaor
Data a wd
%k itpV amen - SVmtxe of Audtar
Date signed
20 _ Pay 20
Lesser of 12 Homestead
Valuation or $35.000
$
Swoture of Auditor
Deb