Homestead_PenningtonCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Sleta Fortn 5/73 (R6 / �-03)
ReaaibeE Dy Me Depsitrrnirt d Loal Govemmerrt Finarxe
INSTRUCTIONS: See iererr� akM Aor Rip bw6udionc
� �e� � � �
I(We) occupied as our principal place of residen e following described real erty for which a F
�1 (We) owned ❑ We buying under wnt2ct
,�
Have a benefidal interest in the entity that is liable for the property taxes on ihe property and �hat
It buying on conirad, Fee Simple owners name
County
Parcel number
where conVaa is recoreed
Tamship
Legal e:
r
I-
sWclure a the land no�
ice i�ome.
disUic� (ciry, fown, fownship)
Is ihe pmpe in que5tiw
pro,
urtounds Ihat s cture is uu
FORM � YEAR
HC10 �
��a4L�q{�e 1sl day of Marcb, 20_
Propei��}a� Credit is hereby daimed:
is buying under a conVaU.
Record number � Pa9e
irty ❑ Mobf�e Homo p.C. 61J-�
W produce income, describe Na use antl portion
- o3Gd -QG � .i(oo13- G�/
_ ,,.. _. _ ._. ..- • - -- - - - -
�-���.,.`�'+�a`�:--��'�-''"'"..�j:£:'�RROPERTY>OWNED`BV'CL'AIMANT,IN':OTHER'COVNTIESz s..��`�'�=?-':��,,.��r.`�.�?`�i"t�i
_�_.,._
County Tavnship County Tavnship
I hereby certify the above statements are W e, cortect and complele. Si ature of claimant
�dress (number arM streef, city, sfafe, ZIP cade)
���3.�"�•:�',a`f';�- """p�3€.�i*F�'y'l�:,r 1`xr-�" �-t; �' "`}'��- . . , _. ... �„ �-� -{• - -.y .
'� ASSESSORFUSE ONLY Es,.` � F�s�.TRUE TAX�*� ASSESSED VALUE �HOMESTEAD F{-+� NON;RESf0ENT1AL '�� r�
�-�'�.s.�����='k.,4'� ` ' r-""'v` =..-'�.-- �.,�� r"r�c"?,'.YALUE...C. �:.s ��ATi100°/.,OFf.T�yv` .,-c�`� VALUE� �w �,'k3�`ry,.VALU�`�`�F.�'�
Land nol exceeding 1(one) acre immediately ='�'��"c�",�'��,�;r�- }
surtounding residendal improvemenLs. (�) � ��.��� t,��a`�.�
� �
Other land (y) �#��:����
�.>,. -�- x
TUaI land (line 1 plus line 2) (3)
�e. �.�.az;�°z ��s������ .-4':;
Dwelling (4) `�-.'�'�_��:,���-7.'u�F��;r�zsd'���R,-�{
�RasideMial Improvementa or MnuaOy
Mae�ad MobOa I Alanufac4�red Haro Gara e ��'�3 ..,,' "��:,•�'F"''' �'
9 (5� �z'''° .,.:'.�.'z..`�.�..��'�..f5.';�
Otherimprovemenls (6) "�+��i�� �Y a
`��ti �'-�7,�,r •�-� ��
Total improvements (line 4 through line 6) (�)
T[1al value (line 3 pLs line n (g)
I hereby certify Ihe above is We, corred, and Signature otnssessor Date signed
complete.
Vrrilying aclion - Signature of Auditor Date signetl
`�'''-���'���.::�p�3y�v�y-���.; ��STANDARDAEDUCTION'ALCOWANCE;Sx!`,.�.�>-"�,e'.,,��y�-�,�"'h-*� �'��',v�-„s,�E"`-"-:�",x�"-�tb-'w-�'-:
20_Pay20_
Lesser of 1/2 Homestead 5
vauamn a 535.000
Sgnawre of Pnditw " Date sgnetl