Homestead_HolcombCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
S1ate Form 5473 (R61 d-03)
Presaibetl by ihe Department o/ Local Govemmeni Finance
INSTRUCTiONS: See 2verse side for filing instn�ctions.
�"� OR �� YEAR
� HC1 �
MAR 1 4 2006
°� � p'ra��-7. Ni
��e) GIBfSvOthrytCoOM' UfiNe iYst d�Of�npAyrch. 20
I(We) occupied as our 'n 'pal place of residence ihe following described real property for which a Homeslead ProperFyT�cTCreAdit ia hereby daimed:
�=�We) owned ❑ Are buying under contract
' Have a benefidal interest in Ne entity that is liable for the property taxes on the property and ihat owns the property or is buying under a wntract.
If buy'vig on conVacl, Fee Simple owners name
Recorders olfica where canVaa is recorded
' � :'-<8. � � - �t`� �r'� .� : 2 .� ' i i . � ; � § : ti -�u. .+ h _ L : .. � 's's' � � '.' =.Q,
Counry Tamsfilp
Parcel number
ol the resiaential swcture or Ne Wnd not
y utiGzed to produce income.
—ii —.li—
�hat
Rewrd number � Page
Tacing dislrict (ciry, rown, fownship)
Is Ihe P�PenY in question:
�ealDraparty ❑ A7obileHwno(I.C.6f.f-n
wnounds that sWCture is used b pmduce income. Oescribe Ne use and ponion
�"'`s' � F� � '� ""' �y`�� -�-'+7,'s�''�:� .'�'"TRUE,TNC $ ASSESSED�VALUE � HOMESTEAD �NON�-RESIDENTIAL�''` ��+
��._�} �'�'R,� ASSESSOR 11SE ONLY �`� � }� .yqLUE'"b'� ' "AT 100°h"OF�TTV� ��;VALUE�� ���.�'sVALUEd�w..�i���
v£�wfi .'..::fi 'S�" 4.�.'F .'t. f.S�,� �t4.` ...Y..?.�uY
Land not exceeding 1(one) acre immediatety $y �+�. � 3. �'
� ��� -i '{��'.X"'-�.ri,P.�'s
surrounding residentlal improvements. � � ��.,��. �,��,�'�� �-����
Oiherland `�' r����
(Z) f�'��M`
�.. �.-o�.�::-a�-._-_: �+:i
Tdal land (line 7 plus line 2) (3)
� :�s ���3 �4�..�7.��
Dwe�ling (4) �¢;�''^ �, s P •
Residentlal improvemenLS or Mnualty �� C9i�
Assessed Modle / ManufafXUred Hame Gara e r� E s� �%��
9 (5) :�.rY;`$�, "`.,�-.� � -:� �
n:=�.Ti"i � �;x. �
Other improvemenls (6) �� �;��'�:`-
,� ���`�.+�'
TUaI improvemenls (Irne 4 through line 6) (�)
T�lal value (line 3 pl�s line n (g)
1 hereby certify �he above is We, corred, and Signature ofAsseswr Date signed
complele.
Verifyi� action - Signature oflwdiWr Date sgned
� ,.,rt . _ ...-�
`-�s+�S,u'aG.�r�-�� �,.�s��rfn�isp u`t�'i�i'"��aSTANDARU:DEDUCTION�'ALLOWANCE�� -� - """�"'"'` �_ v' `�'
f a- �.��'_'^'ut�i�:�,�`1�u`.K!f-G�_�et�..�aZ�'e
20 _ Pay 20 _
lesserof 1i2 Homes;ead
ValuaLOn a E35.000 S
Signature oflwdilw ' Da�e signed