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Homestead_PayneCLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD OEDUC710N sm�e rv� s�ra �t� i soe� r�eeoaee M uie oepaanera af Loo� Goran,aa France INSTRUC710NS: See iaverse side Gx filing 'visbucSons. '-'.t'� r- ... ��-.,�'-,. .".... :;.". ...��:C82TIFlCAl1 f• - , + � ', ��' N I(YVe) �e�r rTjr tha�i 2p �(we) oca,ped as wr dpm qa�e w - the fo6owiny .ea� poperty ra wnicn tead�Pm� �tA �mee: G BS ��(We) wmed ❑ Are Wry"vg unda mntrad Have a bene6dal uiteres[ m ihe enfity C�at is liahle 6w Me property faxes m fhe popaty and Ual owns the property or is buyug under a oontrad t.': F .'P.'{..� — iF.}�� . ' ..� ... :. . ' �`.. . r;.�•� a'r..:.. ..1:.' If EllyllA M OOfIb2L�, %BB $IR�IB ONBi8 R2RI8 f�cudefs ot6ce whae wNac4 is recnrded T�uhip nunber pwEan d Na rmidaqial Ww9ae w the Iad praparty Wf¢ed m p�oera'vimrtie. Re�ud numher � Pege Tmmg di9rict (dy, Emm. tar+tsldp) �!% +��LC,L / � � I � �� b ❑ MoEib Fbma (LC. 6/./-� . nal � 9 ane (1) aoe Met i�uredmlely wnoia� tl� �uchae ia ua�d lu WoAne noortie. Uesabe Iha iae md paCm a�-��-ag-aOO-oa��S-o �-/ :. . . . ___. - , .r, - . y. . t : .�, r � r;��,.r .� :-�.,.�t.?�PROPQtTYOWNED'�BY•CLAWANTdOTHHtCOUNigS1,.. �',' .,'f+.bt�'-�v.'>.e -r t, . � ��. _. :. ..v. � . . �;`t� Counry . Tnrnship Counry 7ownship... � tiereny osrety n�e abwe sta�ts are we, oortea and corrpem. �e a aamaa .. (`�;..: i " ��.�� 5l S � 1J �-I "1 x . .: . �� . . , f, r �. �, TRUE TA7C c � � ASSESSm VALt}E F101ff_STEAD � 4 �jr" NONilESIDHdT%1l`{�""�', c �!�',' �„� r... /LqgSSOR�USEONLY -�w,w�z,��^ i VALUE' ..;AT�t00XOFTiV sti �VALUE � � tn''"Y'�,s;`"YALUE "d.' `�ca+�� a < � a, t� tt'�� x's.n,��2 �Y:. �...fiSG�.+�,u.. .. .+ �.' .y�i.., .., . ,. ..� ......... .... �,....:,.�. ..,. . Lend not ea�eedng 1 (one) ave imr�ately �.:� ' • " a� � � �'t �x��4Ay` ^.3{`� ��=��i SllfOlII1dR10f@51�flfl�IfflpfO�L'AICIIiS. �� .ts�e«iT�i�.'n� .hf ii'�h>tk��t:�3 +fi y� Olhet Wnd � �. ". ' . ' . �Z1 +-_ ,. `.::_;�`�"„�=; Tdal land (lc�e 1 pirs 6re � �3) ; 5.�4 �.evx��h& � x z :� �,a y, r x jo a �`�.ra.{tl !yr� RBadentielunpfOVenenlSOfMf1u211y �6� (4� ��'�".w�.��"`+i`�6°�''?„`,.�`D�L�"t�5 Assessed Alobile / Maznf(eW1Bd Fbrt�B rr „j'zn nz}.<� w� r� e m� � Jr �:� Garage (5) tj `o��`^"}�aT�za 3 y�� G 14 �' Oi�IBI IITIPfOVIMfItlI� �6� `P' b,, c�t St1 �t•i 7 s � t i �: '` a?: Tdal "vnprovererAS (fvre 4 tluough 6ne 6) (7� Tital value (1'v�e 3 pds Hne � (g) I hereby oertiy ihe above's true. carc.d, and SiBr�ve of Asa�sw Date aip�ed mnplete_ �9riy'ug adian' Si�m4ne W Pa6E� Dete sipned �. �a c tr«� -�;SUWDARD�DFDUCTION'f1Ll'OWANCE�} ::ti.:>us" :i°�• ,a`.,v.�y��3� : n4f �;�'.��'�'(=`E1 p—P�p— � Lesserof 72 Hotrestead Valua6an w 535�000 S Sipnatura of aditu �ate sqned . . _. _. _ _ .. . . . . . .. . ..... . . . ' ..-_ _ ___-_�_ - __'__'__ _.___--___ ._ _""_'