HomeMy WebLinkAboutHomestead_Jones (5)_ ' CLAIM-FOR HOMESTEAD FROPERTY TAX
° CREDIT/STANDARD DEDUCTION
t Sfate Farm 5473 (R6I4-03)
' Presaibed by Ne Departrnatri of Local Govemmant Fnance
� INSTRUCTIONS: See reverse side for filing instn/etions.
��
, F�R � YEAR
MAY 5 2005
� �e) ` certify ia�rsavtv-�UU�fY AOVITOF�—
I(We) oxupied es ou rindpal place of residence the tdlowing described real property for which a Homestead Property Tac Credit is hereoy daimed
�� I(We) owned ❑ Pre buying under convaa
ave a benefidal interest in ihe entity Nat is liable for the property taues on Ihe property and that owns Ne property or is buying under a conVact.
�:i��xr'�e$i-..k.^'t f�v`r +..�.�i"'z`-':�„���t'}:��s�'.'f'➢`xr-R�t';zki.ti� CONTRACT;RECORDED `& _' . - - � ° � :, c f ����--
If buying on conVact, Fae Simple ownefs name
Recordefs ofice where conUacl is remrded Record number Page
Counry
Parcel number
005 � �c
It any portion ot Ue resid
w ma roaem �ni�ed w
Tavnship
Legal desuiption
l � � l..J�\
sWCture or Ne
ice income.
��J , �/.
Tmcing district
not exceeding one (1) aae that immediately wrtounds Nat
al ptoDerty LJ MobOe Home (I.C. 67.7-n
is used to pmduce income, describe the use anE ponion
� t�'°£'``£'�` �`��"r`-'i`� �'�� �g�.��TRUETAXY"`�3 ASSESSEDV/1LUE �" HOMESTEAD �"`�'3�'NON�RESIDENTIAL�`� �'�-
��,����ASSES�OR»U�E�ON�Y� ¢� �3` ��+��; k�v.V/iLUE�+n �' AT�1,00%OFcTN� �<rVALUE"`§�3 �� �� -t fe��'�'VALUE�''� �R ''���
i... ' F' s t <,� _ �'r�:�•.. ._.. as
Landnotexceeding 1 (one)acre-immediately ��� s;".w', � y-�!�, �r��,'�`�j.s �„'�
surrounding residential improvemenLS. p,; �, �, +��.:; 4 i: ,,i c 4;
�.�.
Other land �y� - — �
Tatal land (17ne 1 plus line 2) (3)
DWBlling (4) '-`'._�, .. �,�` 7+'-F.,' a F7." r+: y.i.
Residenlial improvements or Annualty ,,:,.� .� ,,:i � -�r .,-' °'-x
Assessed Mobile / ManuFactured Hwna zv' � ti,'�� �� "3',5,� -
,:1 .,
Garoge �5� ;d;. � ..,�f.: �' f'= .r?...: ; :.:..:
. a_,-.,_,:,- ..
O�qer improvements (6) �;y �'
7atal improvements (line 4 through lirre 6) (7) .
7atal value (lina 3 phs line 7) (g�
I hereby certify Ne above is We, correcl, and � Signawre oinssessor - Daca sipned
complete.
Vailying ection - SlBnawre oflwditor Date signe0
m
20_Pay20_
Lesser o( 72 Homestead
Vaivation or $35.000
S
SlgnaWreotN�EiWr � ^ , Iva�asi�nea
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