HomeMy WebLinkAboutHomestead_Hedge� CLAIM FOR HOMESTEAD PROPERTY TAX �.F,ORM . YEAR
���CREDIT/STANDARD DEDUCTION HCio �
SiaieFOrm54731R6/403)
Prestnbed by ihe Department of Local Govemment Finance
WSTRUCTIONS: See ievcrsc sidc loi filing lnstrur:lmns. ., j'�oo L
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� _s�� k 4 �.� t �i � i .-:-.:-c,-.*.�•:,-...-;n-t.: -.- . � .CERTIFICATIONSTATEMENT" - ._.. � � � � �
I(We) �y`���(� �� 1 � �g}��� m 0 [� certify that on the 1st day of March, 20_
I(We) occupied as our principal place of residence the following descnbed al property for which a Homestead Riaperty Tac�Qte�iStds'hereby daimed:
�� Y
� I(We) owned ❑ Are buying under coMracl
� Have a beneficial interest in the emiry ihat is liable for the property taxes on the property and that owns �he property or is buying under a contract.
..a=i"K'xx '�"-rs-z-�:-'�"f :i:.-.: "i,�..._.....,. _ " ". . ..1��.�:,: ` CONTRACT�REC�ROFO:, .-._. .. . _ ._. - , . .�. _., . >,-_ .
It buying on contraa, Fee Simple owner's name
Recordefs olfice where conUact is recorde0
Rewrd number � Page
� Y--��i.^: � - '.���"--.:PROPERTYDESCRIPTION�. - .. ' - �--:�' . - �-
Counry Toxnship Tacin ' triq (riry, fow row iP)
Parcel number ''\ al E scription Is Ne pmperty m question:
� - '(J.J - ` � Real proOertY ❑ Mobile Homo (l.C. G7.1-7) '
If any portion of the resiAenual swcwre w Ne Wnd not exceeding one (t � acre that immediatey surtounds ihat swcture is usetl b produce income, desaiba Ihe use antl ponion
of the properry utilized to praduce i�ome. 1�.�j7 � OL
O
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�- cF,�£:-'�`a�'O�:`:`: _:�+.. �:r" 3 "� =:.�PROPERTYOWNED'�BYCLAIMANTiN'�OTHER"COUNTIES � ` _•..> -�+'��°Y:•n,�.' � � . ...=:.
County Tow�nship County Tawnship
I hereby certify the above statements are We, correct and complete.
Si ature ot claimant
Adtlress (numbe� and sheet, ciry, s(ate, ZIP code)
"�'"k`i + i?�T'` � ' �"��" � -� ' " TRUE�TAX ASSESSED VALUE � _ HOMESTEAD ' NON-RESIDENTIAE�
�: y � '� ,ASSESSOR USEONIY �. • ypLUE AT 100%`OFTN � VALUE `Cr;S.�VALUE �• �� ��
,.��{.aw�. f r...:++.,`�°"'�:. � .
Landnolexceedingl(one)acreimmediately ='?'���`+��'%""'==��� .
surroundingresitlentialimprovements. (�) . �. ' � -, � I
Other land �p� - - .
Total land (line 7 plus line 2) (g� �
Dwelling (4) .- .; "' � i; :`.:.�� _ .� � � ,,.
Residen6el improvements or Mnually
4 .:� �
Assessad Mobile I ManufacNred Home Garage 5 f`�-^ ¢'. `• �, �
( % .\. ..
Other improvements (6)
Total improvemenis (line 4(hrough line 6) (7�
Tclal value (line 3�plus line � (g�
I hereby certify lhe above is true, covect, and Signamre ot Assesmr Daie signed
complete.
Vedfying actbn - Sfgnature oflwtlitor Date signed �
`'^. .'se.� -,` � � � '- � -� - -STANDARD.DEDUCTIONALLOWANCE"�' �� ' � (.f:,;:�..� �
, . ` O / lt •'O ,--
20 _ Pay 20 _ � �4
Lesser of 172 Homes;ead
S
va�uauon or 535.000 .
SgnaWreofAuOitor ' Dalesigned-��_