HomeMy WebLinkAboutHomestead_Glouser.,�ry� t CLAIM FOR HOMESTEAD PROPERTY TAX
- � CREDIT/STANDARD DEDUCTION
` J State Fwm 5073 (RS / 10-01)
���� Presrribed by Ihe Department of Local Govemment Finance
INSTRUCTIONS: See reverse side for filing insWctions.
� �e) T certil
I(We) o pi as our principal place of residence the following described eal property for which a H��o��gst�
f�
I(We) owned ❑ Fve buying under contract .j�
Have a benefidal interest in the entity ihat is liable for the property taxes on the properry and that owns th �
.�
� a�:sa. `��''�` "a'�";'ct° r.�." ..t .:`.`z�.`�.-�^` �. �=eCONTRACTRECORDED � �:'_ � 'S�'-+..,
t.,:F!-�� _,rt:-��ir r�3:� v�,: i _ 'r�.°
I( buying on conUad, Fee Simple ownets name
G!BjCN
Remrdefs otfice where contract is recorded
County Tavnship Tacing ' ciry, fown ownshiP)
P r r gal description Is the pmpe queslion:
^� Real pr
porlion a( Ne resitlentia w the land not exceeding one (7) arne mat immetliatety sunounds that s�y�
of the property utiizeA W produce irrcu . ` �\
_ ' OlY
_ /a-��=�OO-�o��i9
I hereby certify the above statements are W e, covect and complete.
�7ress (number aiM s6eet, ciry, s(ate, ZlPCOde)
Land not exceeding 1(one) acre immediately
surtounding residential improvements.
Otherland
Total land (line 1 plus line 2)
Dwelling
Residential improvements
Garage
Other improvements
Total improvemenfs (line 4 Ihrough line 6)
T[tal value (line 3 phs line �
I hereby certify the above is W e, correct, and
complete.
Verifying aclion - SignaWre oflwdilor
��)
(2)
(3)
(4)
(5)
(6)
P)
(8)
SignaWre of Assessor
ol Claimant
FORM
HC10
YEAR
,�.ir — ,�ryi;_.:: -� _.
Ihat on the 1st day of March, 20_
P perty�re i i ereby daimed:
�rooertv or is buvinq under a coniract.
Record num�er � Page
bile Homo p.C. 67.1-7)
ce in�me. �ibe thlvs/^'.-v�y'-"
•
Dale signed
Date signed
���'�=ia• �. ��'.:s.a�ii ��' �ir�i`3s�:'�i�� ��: STANDARD'.DEDUCTION�AL:LOWAMCE s�+`.j:�?t"t� 4�rss�iA..'-�`iue'a" .�'� >��3�3s`".�.*`i<3�"1;-`r' �' _
20_Pay20_
Lesser of 1!2 Homestead
Valuatlon or 56,000 S
Sgnature oflwddor Date sgned