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HomeMy WebLinkAboutHomestead_CurtisCLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION State Form 5473 (R6 / 4-03) Prescribed by the Departrrront of Local Covartmem Finance INSTRUCTIONS: See revwco aide for filkV irnbucitim ' MM= JUL 2 7 2005 STATEMENT r r .mss..° y7r."= . s, . x:.vgpiTf - ?ity�' ^?`3 't.. >i „d`'•,, I (We) O certify that on ttchnee 1 q6gj $" 13DR (We) occupied as our principal pl of reside the following de be eal property for which a Homestead ProAfsl ac Credit is hereby claimed: 1 (We) owned ❑ 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. s*,•:� -.c `zCONTR{1CT'RECORDEDs�{y �a�..,r �`.. =•s- �?t}:vu•,��ayrR,i��v.t,�rs - 2i1�'da-�K If buying on contract. Fee simple owners name Recorders office where contract is recorded Record number Page ;= -- :Iux %° ' .t -tai ''r 6� r ?P,ROFERT,`/;DESCRIPTION'"e'Y County Township Taring district (city to , township) Parcel number Legal description I the property in estion: V v �_jr`VALUE�+1. ❑ R property ❑ Mobile Home ( /.C. 6.1.1 -7) H any portion of the residential structure or the land not exceeding one (1) ace that immediately surrounds that structure is used to produce inane• describe the use and portion of the property utilized to produce income .� - O -OOH '90 / /O - - - - ROPERTY: OWNED��BY�CI 'AIMANT.IN:OTHER'000NTIES.� : �= �-. ��. ??��9 '"•�:).�?��u°_�F':t�!��"_`��. County Twrnship County Tovnship hereby certify the above statements are We, correct and complete. Signatur f ctaimant ddress (number :=t. city, state, ZIP code) IPIe /GO l.Ae.A ; y7G6S �3 ASSESSORUSE ONLY = z TRUEeTAX�u?- ASSESSED VALUE .�HOMESTE?J NON- RESIDENTU1L�g' �� +r .y�VAI.UES ar /1Ta100 °/.,OFy'T7V VALUE �_jr`VALUE�+1. Land not exceeding 1 (one) acre immediately surrounding residential improvements...�vtr.�'Mc,,2��'' F` Other land.:" Total land (line 1 plus line 2) (3) Dwelling (4))., Residential Improvements or Annually' .,G.z Assessed Mobile / Manufactured Hama Garage (5) Other improvements (6) ?:' �'•'• � Total improvements (line 4 through line 6) (7) Trial value (line 3 pf s line 7) (6) I hereby certify the above is true, corned, and Signature of Assessor Date signed complete. Vedfyug action - Signature of Auditor Date signed