HomeMy WebLinkAboutHomestead_Grisham Investments Inc\ CLAIM FOR HOMESTEAD PROPERTY iAX _
! CREDIT/STANDARD DEDUCTION
\♦ I� SI:tleFurm5373(R6/4-03) ��Tppp���'''' .'ttlr �..� . ' " � .
� PrescribeC by the Departmenl ol local G�m�Fi� no: 6...! .� �
p�'
INSTRUCTIONSr See revcrsr. sidc or /drny �,a �ir�--�
� FORM
� HC10
YEAR
r'•.r Z� � "'-.-: -.�-:°:•• ,.*:.'-:'S� - _<-`M ,G F NSTA7EMENT^ e.r?:i! -.- � _ ..c��. ..
I(We) � certify that on the tst day of March, 20_
I(We) occupied as our principal pl of residence th f iRS�tl eal property for which a Homestead Property Tac Credit is hereby Gaimed:
❑ I(We) owned ❑!ve buying under cSa1�SAN COUNTY AUDITOR �
` Have a benefidal interest in ihe entity ihat is liable (or the property taxes on the property and that owns ihe property or is buying under a wnVac�.
County
P el number
_(�OS-p_�515
If any porticn of ihe residentiz
al l4e pro,xrry U6lized b pra
N/ -
Tavnship
sWCWre or the land not
ice income.
ESCRIP.TIONi�:?Y"_-"��=_=:,y,... ,:::�>s: _ =:e�r�:..�-.�.- .
T�ing tlisVic� (city, fown, township)
�A I Is Ute property in es�ion:
pReal Droperty ❑ Mobile Homo (I.C. 61.1-7)
aae tnat imme0iatety surtounds Ihat swcture is used to produce inrome, describe Ue use and portion
i W ' '�t �" �`�ri S ��`�''s"f� ��� "`TRUE;fAX � > �ASSESSED VALUE `' �HOMESTEAD�"- "`�v -s� NON-RESfDENTIAL`r` ?% '�•
r . � ��.��;ASSESSOR USE ONLY � �{�, vg. 3ss � ., � � o .,�.y .p` .,,+-.�i i ;z. S � ��
S.: x.�'rn3l-_.._CO?!s`_kr�:F�. t��..,..�R.�.'+.�u...;zt`_�"`}••VALUE:`l ,�.�,.=AT100%�,OF:TiV .�VALUE;r's'.,.�..�r..�_-_�t??.'-VALUEr�.;�i.r-�-�q<<
ors ?�.v_ �,
Land not exceeding 1(one) ac,e immedialely- `SsG.��h�-r-�$"`? ;�P 'p� --�"-��v .:
surtounding residential improvemenis. �� � �l, �'4��i •a�.�,�v' ;.;-�.,��.��; �
Otherland - � , �2) � ��'a.'�; �.�,�.°�
.a-,..x:�'!.��:. �_ f.?:
Tdal land (line 1 plus line 2) �g�
� �r s. -� . �„ � ':
Dwelling (4) s v��' ��� ��-,.��..
Residen!iel improvemenLS orMnually � ���'�' -`'- '" � "�
Assessed Mobile / Manutadured Home Garage (S) �� y' �i;.����'�'�.v "��r';�
tr,-.• a�g;`'.�-!; : _�a.�T r.',;�s;� ."
�TM�;'��W � . '. ' _
Other impmvements (6) r�r 2 .
- �`�<Yf,:d.b�..:
Tdal improvemenLS (Ilne 4 througb line 6) (7�
Tctal value (line 3 phs line n (g�
I hereby certify ihe above is We, corred, and signamre otnsseswr Date signed
complete.
Veiifyirg action - Synature oflwditor Date signed