Homestead_Morton�
"'" CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD / SUPPLEMENTAL DEDUCTION
S�r � State Form Sa73 (R72 / 609)
�� � Prescribed by Ihe Department M l.oml GovemmeM Fnance
INSTRUCTIONS: See reverse side far fifing instivctbns.
:� t •' ;� ��
,
�` � :� S .�
�
' � � �
� �
is filed, (date of filing):
(We) ovm ❑ Am (are) buying under recorded mnvact
Am (are) enlitled lo occupy as a tenant-stockholder of a cooperative housing corporation
� Have a beneficial interest in ihe Wst or the right to occupy the property under the terms of a qualified personal residence Wst
•- • •
Sodal Seariry numDer f daimanl's spouse (lasf five tlig'4s) Drivefs license / ICentifipllon /
•
. .•� .
11 buying om m�tract, Fee SimpM owneYS r�ame '
RecoNefs o16ce where mntract is remr0ed Remrd number ' Page
'"�• • � . �
Counry TamshiG Taw�g disvicc (", lown. township) .
Parcel number Legal tlesaiD� Is ihe pm ' qurstion:
— � ( I Woprrty ❑ MnwOy assessetl mohile hane (IC 61.7-7)
If any poriion of the �esidential shucWre or Ne IaM not exceediiy7 dia (1) arne that trnmetliatey wrrouiMs ihat swcNrc is used to pfoduce Inmme, Eesrribe Ne use and portion
� of Ne P�PeM WT¢ed lo praduce incm�e.
• � • • � : • •
CouMy Tv.mship Caunry Township
I hereby certify ihe above statements are we, cortec[ afM complete. Sigmt re daimam • -
ss (^� � i% nA 31 aN. srste. a���' d ��� � (�L V!
�. � � • .� • �
��'. �
Land not exceeding 1(one) acre immediatety ��:r=^� ?�'..�",�...� �� zti�rY�
surtoundi residentialim rovements. i�) �.^,?`���;�i�j.Fp,,.:. :. Ffrx,<
.�,� r
Othetland (2) � � ���s`}'�k.'Y-u.y�g
Total land (line f pWs line � (3) .
Dwellin 4 - S':3��c�'h-t�i�� L�r'��``�a.a.�
ResldenUal improvements orMnually 9 � ) �:•.x�'n. _�'-'_ :.:�it��. ��+3iw?-'�i:
Atsessetl Mobile / Manufactured Home Gare e `��'" y s��=
8 (5) .�:ttc'� �����'.x.��
q;.`.Au;r,.-�„"�'`t,
OtherimprovemeMS (6) ;�:�t�,�,j:i.a'��.� �
Total Improvemenb (Ilne 0 Niough line � . (7)
rorai vame (line 3 plus line � �e)
I hereby certify the above is W e, corred, Sg�n"e °f Azs°ssw . Date sq"ed (m°^th� Eey yea�
and wmplete.
Vaifyin9 action - SSnaCi2 o(�tor , Date signed (rtronN. daY. Y��
� �.-� � � � •
20 pay 20 _ Lesser of 60% of the assessed value of the homestead or 545,000
NolwVhvaMUg enyWher pmvision, fhe sum ol the deticrlions proNtletl in IC G f. f-17 ro a mo6�7a Mme Nat k $
rrot assessed es reel properry a 10 e rrenuteUUred hnrn Nef a not asseued as reel properry may not exceeC
one�hatl(1Rl d Ne essessed ralua d fAe mobde hame ar manufarlured hwne.
Sgnatufe o1 Audl Date signed (monlh. daY. Yea�
1 l-