HomeMy WebLinkAboutHomestead_Griffin- CLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
Stete Fwm 5473 (R614-03)
Prascribed by Me Departmem of Local Govemment Finance � �
INSTRUCTIONS: See rarerse side Iw filiig instrvctions.
FORM
HC10
-YEAR
I(We) �,__ Q�(X/�P ���'`� �m,,(^'Q,���� R�"�•� • certify Ihat on the 15t day of March, 20
I(We) occupied as our princi place of residence the following described rea operty (or which a Homestead Property T�c Credit is hereby daimed:
❑ I(VJe) owned ❑ Are buying under coniract
, Have a benefidal interest in the en6ty that is liable for the property taxes on the property and thal owns the property or is buying under a wntract.
If buy'u�g on conVad, Fee Simple ownefs name
Recoidefs ofice where contraq is recordetl
Counry
Tavnship
CJC�J�-V•`1�`I�b'UVI._�_�_. n;�p•i�rr�rlG
I( any poAion of Ihe resitlenilal sWqure a U�e Wnd not exceeding one (1) aae t�at
ot tha property utilized to produce income.
Rewrd number . � Page
Tacing tlistrid (city, town, township) .
Is the praperty in quesUon: ,
� ❑ Real property ❑ Mobile Homo (/.C. 6f.7-�
ime tely surtounds that swaure is usetl W produce income, desaibe ihe use antl poNOn
-/7� y /�o - �a�:'.�yG- �
Counly I Tavnship .
I hereby certi(y ihe above sfatements are We, conect and complete.
�dress (numberarnl strrel, city, sfafe, ZlPCOde)
Counly
otclaimant � ,
�
i�����'S'r AS5ESSOR SE ONLY � � �'`�� �TRUE TAX�ki° ASSESSED VALUE � �HOMESTEAD� � NON'-�RESIOENTIAL ,Ti
�..��?_Tr zz.�^=2- . � '`��3�LVALUE.i�?a...�..AT�100°�OFiTTV�;d''�+�+'-'sVALUE.u`�.�".-�.c���E�i�i!i..'�AI.UE����
Land nol exceeding 1(one) acre immediately wk?��;�,�-,�.�'.�...'�`�-'��y,�wn '
surrounding residential improvements. (�� :`���.�.s"_ �. �,,,��r�F�3�
Other land (Z) ������-� ,u
r..c..::� �x.d +.. :
Tdal land ((ine 1 plus line 2) �3�
: '� `s: o -�`� ..�3i
Dwelling (4) '��A:`�t.Zi-�-�w.�` .a5"u..�iT�°„'C�.r,t��
�Residential improvements or Mnually ,� ,; �� T�
Assessed Modle / ManuFactured Home Gara e ��i�� <� �
9 (5� �`y'�'^'�r�.���������
;: ��a- u: �i
Otherimprovemenis (6) s�=t�;� • � �-
'� s"e! � .'� .k�'�.+�'�
Total improvements (line 4 through line 6) (��
Tdal value (line 3 plus line n (g�
I hereby ceAify the abOVe is W e, coveG, and Sgnature otAssessor Date signed
complete.
Verifying action - Signature ofAuditor Date signeA