Homestead_OffermanCLAIM FOR HOMESTEAD PROPERTY TAX
- t CREDIT/STANDARD DEDUCTION
State Form 5673 (R8/ 7-07)
•� •�,. 1 Preuribed by Ihe Department of Lotal Govemmenl Finance
INS7RUCTIONS: See reverse side /or filing insWcfions.
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AUG 1 2 2008
I(we) �J "tKe 1 st d"ay or'r�,faicK,� 4b"'
I(VJe) occupied a r prindpal place of resid nce the tollowing describ al property fw which a Homestead Pmperty Tac Gedit is hereby daimed:
�I (We) owned ❑ Me buying under eontract
Have a benefi6al interest in the entity that is liable fw the property faxes on the property and that owns the property or is buying under a contrad.
If buying on conUaq, Fee Simple ownefs name
Recoidera of6ce where coniracl is recortled
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Counly Tavnship
rcel number
" �'l-�u-.ic�o- �.� ����c_. � oa� i
of the residenUal siructura a ihe land not enceedirg orre (1) acre that "vnmetliately surtounds that
y uU6zed to pmduce inmme.
legal descriplim
Tacing diWnct (cdy, town, fo+mship)
Ihe
Record number I Page
al pioperty ❑ Mobile Home (IC &1. f-n
is used Io pmduca income, describe Ihe u5e and portion
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Land not exceeding 7(one) aae immediatey ��_ = .
surrounding2sidentialimprovements. ��� � • � - - �
Other land (p� � . . . . .
TUaI land (line 1 plus line 2) (3�
Residen6al improvemenls w Mnually �ellirg (4) � . o� :r ..,' .
Assessed Mobile / ManufaUUred Hame • - " - � - -
Garage �5� " . .`,, ; - •' r'.
Other improvements (6) , . �-
TUaI improvemenls (line 4 through line 6) (7�
Tctal value (line 3 plw Grre � �g�
I he2by certify tlle above i5 We, corteU, arHl SignaWre of Pssessor Oate signed (monih. tlay, year)
complete.
Vaitying adion - SignaWre of Pudibr �ate signed (month, day, yea�
p— PaY 20 — 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
lesser of 12 qq.000 for 2008 pay 2009 41.000 for 2071
Homestead ValuaCOn �Y 2012 S
w 43,000 for 2009 pay 2070 40,000 payable after 2012
SynaWreoflwdi(w _ , ,
Date si9ned (mm1h, day,
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