Homestead_Davis (13)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDMSTANDARD DEDUCTION
Stara Form 5473 (R7/ S-0M
Prescribed by the Department of Local Gavernrnerd Finance
1N.qTP11rTl0N.q-.Caw m.ron eW. in, fflinn
FORM YEAR
Ct
L/ 'A'A A . certify that on of V&Pch, 20—
as our principal place of residence the following described real property for which a Homestead P&1AWl%vC0UWYhW9)#Tdb1ned:
(We) owned ❑ Are buying under contract
a beneficial interest in the entity that is liable for the property taxes m the property and that owns the property or is buying under a contract
WjWga? %',CONTRACT, RECORDEDTfifiT:
If buying on contract. Fee Single ownees raxne
Pecordeftaf5cewhere.1b ctisrecorded Record number Page
&W,Wi Mo- PFt0PERTybEs-ckiP,,ndW,'
1-urd'
Ticurnshl . p
T. d lowq(towns&p)
I hereby car* the above statements are true, owed and complete.
Signaftago dairrnara
1 7�
Parcel Maribor
Legal description
pr,*Vln ua=�
MEL
VAL'.
A
rft
Red Mobile Horne (LC. 6-1.1-7)
tf any portion of the retWential structure or the land not exceeding one (1) acrt, that immediately surrounds that &uc&we is used to prod" income, describe the use and portion
of the property WfizadbYproduca income.
V/
11914 � "?a I/
"N OROPaM.OWNED:dy.-cL mmANttNiOTH - m
County
Township
County Township
I hereby car* the above statements are true, owed and complete.
Signaftago dairrnara
Address (number and street cd)4 state. ZIP e)
AI&V-S- 5 $"5,0 ez"?
g--pgto
• 20 _ Pay 20_
�02,,!
K.
-'----S'-S-'1ED- -VAL@JK
E
`Y HOMESTEAD
�11 WzR �16 -,
O-NON4
RESIDENTUkl!�Ii
$
0RUSE'ONLY-�-,iik
7
_TRUE?TAX -
VALUE' V�
11V
'AT n
MEL
VAL'.
A
L�
Land not exceeding 1 (one) am irrynecizately
CA
'
suorounding residential improvements.
Other land
(2)
Total Land (lire I plus &7e 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile / Manufactured Home
Garage
(5)
NrIffief,
W N". R4
Other improvements
(6)
Idal rmprovernents (roe 4 through fine 6)
(T)
Total value (line 3 ph& fine 7)
(8)
1 hereby certify he above is true, correct. and
SignstureofAssesses
Date signed
complete.
Verifying action - SVnature of Auditor
Date signed
4STANDARD'DEDUCTtONYALLOWANCE', rut ftm , Z� ft?
vffft; 49WI, ffix
• 20 _ Pay 20_
Lesser at 12 Homestead
$
Valuation or SM.DDO
Sgriature of Auditor
Date signed