HomeMy WebLinkAboutHomestead_Flener (3)° CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
` ' State Fortn 5673 (R817-07)
H'escnbed by Iha Departmerrt of Lonl Govemment Firiance
INSTRUCTIONS: See reverse side /orfiling instrucfions.
FORM
�� YEAR
HC10
I1�
I�--�C I� V V 1 ��, 1� ry MAt i ��Y -
I(We) I— �-P �. v r- cerfi tha� on the 1st da of March, 20_
I(We) occupied as our prindpal pla of residence the following described real property fw which a Homestead Tmc C ereby daimed:
�aµ �
�❑ I(We) owned ❑ Are buying under contract � _� °��� CO NTY AUDITOR
,�� Have a benefidal interest in the entity that is liable for the property faues'on the property and Biat owns thS'jiwpeny or is buying under a contract.
If buying on contracl, Fee Simple ownefs name
Recordefs office where conVad is recorded Record number Page
..�• • � • •
n / ^ Twmship Tmcing dislrict (tity, town, tv.mship)
� �
numEer Legal tlescnption I Is tha property in question:
❑ Real property Mobile Home (IC &1. 7-n
If any portion o! Ihe residerNal sUUClure a ihe IaM not e�cceeding one (1) acre thal immetlialely surtounds thet structure is usetl to pmtl income, descnbe the use aM portion
of tha property uti5zed to Pmduce income. ._ _.-,
County
-�-�o�. - �� -- -
�iOO- na5��9-
._,.
Tavnship
�% � �/� C���/� �'
County
I he2by certi(y ihe above sfatements afe We, correct and complete. I�9"f'�`��e °f
(num6ei aM sUeeC city, state, and LP code)
//C�K� i.J FCS'�O S D.,�
I— PaY 20 — 45,000 tor 2001 pay 2008 42,000 for 2010 pay 2017
Lesser of 12 qq�000 for 2008
Homeste� d Va�uation PaY Z009 4��000 for 2017 pay 2012 $
« n 43•000 for 2009 pay 2010 40,000 payable after 2012