HomeMy WebLinkAboutHomestead_Hyatt, CLAIM FOR HOMESTEAD PROPERTYTAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R614-03)
Presaibad by the Department of Local Govemment Pinance
' INSTRUCTIONS: See �eversa side /orlling inshuctions.
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M YEA _
H �0 0
MAR 1 4 2007
. _ s�'.i - .. - . - � - S'.r::°:-�.sr'��`--r. .
� (We) � �i_, / / certiry( ;th�B�Un� �d�it�4X9�.C4�F3Giff0
I(VJe) occupied as our principal place of reside the following descrtbed al property for which a HomesteadFropeAy Tac Credit is hereby daimed:
❑ I(VJe) owned ❑ Are buying under niract
' Have a benefidal interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
If buying on conVaa, Fee Simple awnefs name
Recordefs office whera conUaIX is recorded
County
To.mship
Tating
YdfLEI��� / ^U � ��( �p� / / '� �/ I IS U19�Of0
It any ponion ot Ihe resW�llal sWaure w �he Wnd not e:ceeding one (1) aue that immediatery sunounds that
ot the properry utilizetl W produce income.
�(o-/r./7- yoo-ool. 78�F-oa.r
County
Tavnship
I hereby certify lhe above statements are true, correct and complete.
sntl stree(, ciry, state,
Counry
of
Rewrd number � Page
�Ijroperty �/MObileHwno(/.C.6f.7-7)
is used to produce income, describe the use antl portlon
Tavnship
� ������3'ASSESSORUSEONLY .-�,,'��.5����TRUETAX � ASSESSEDVALUE�HOMESTEAD� ''"��NON�tESIDENTUIL?`k'��S
a.. .?+�-,F'<'.-7si e>.��:r�'?� _ vc ,,._3. R* �.1. i�.VALUE� :AT 100%.OF TN's ir .� VLLL.UE�� ���', f.,'v�a.VALUEr-a�.���EYc'�.
Land not exceeding t(one) acre immediately t' 4 �i°S.p�-�'�'n'�� ��?
surrounding residential Impmvements. �� � - T `� �v � �s ' ,`_ ° 3
��d�,.,e �3 ��'�{ ��
3
�'R;=:�, ' "'Ft�i'•„�.t `
Other land �Z) :� :. �-�r�„�}�� :�
; yc...-�.s;,';?,�-
_ x._-
Tdal land (line 7 plus line 2) �g�
`"�u' V�'� ^ �a�
��i- �%�" � ♦if `
Dwelling �Q� �y���js �" v � � Y`..�f [l
I �'.:.iar�`.�i.�ca..�ue`�e;��.a���
Residen6al improvements or Mnuairy
ASSessed Modle I Manufactured Home G
Garage (5) ������cv °�.s��'t ��'�
�~.�`-"_r��k ;y*:k�f
Other improvements (6) = �,+;� �=.a ��:,,^"��
'. �: i�:`t�`.:wa3..
Taal improvemenis (line 4 through line 6) (��
Total value (line 3 plus line � (g�
I hereby ceAify ihe above is We, coned, and Signacure otasseswr oate sgnee
complele.
Verifying action - SignaWre of fwditor Date signed
��t'.^-�-`.$-�..A?s."��`�7c.�."'y'•,ti:�e�-$�°'�.�'-`STAN�ARUAEDUCTION�ALLOWANCE. tiTu"%�i'4:5-i.�:;a.".'�r .�',�r`.`�� �_�`.�c'_��:x��2,
20 _ Pay 20 _
Lesser of 1/2 Homestead
$
vawauon a 535.000
SgnaWre of Auddor � Data signed