Homestead_Morris (2)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
t State Form Sa73 (R6 / 4-03)
Prescribed by Ne DeOartment ol Laral Govemment Finance
INSTRUCTIONS: See ieverse side forllirg instnxtans.
'
FORM � YEAR _
HC10
I(We) N� �`� �- ��- -�;� (.(�-�Mi- . % � �L`i/Z.C�.li ' - certi(y that on the 7 st day o( March, 20_
I(We) occupied as our principal place o( residence lhe following described real property (or which a Homestead F��ty Ta����s hereby daimed:
��I (We) owned ❑ Are buying under contract
� Have a benefidal interest in the entity that is liable for the property taxes on ihe pwperty and that owns lhe prgp�f�.c� i��nqhq under a conUact.
I( buyu�g on contrad. Fee Simple ownefs name
Recordefs olfice where wnirad is recorded
��tT�' .�.�x'�,",r�`y �mv'yr > �+_�a��'S
{� Tc. 'is�Ci�5E2��i:���iY3. _�V
County 7oxnship
(own,
Rewrd number � Page
Parcei number Le9al descnption V j s4-� /-3 �,,. Is Ne p d
z6 -1 %' � �'�' DO -Ob/, sb� -a � j 37• 3- A C. OnReal pmperty ❑ AAObila Homo (I.C. 67.1-�
It any poAion ol the rcaidential sW aure w Ne land not exceeding one (1 � acre that immetliately wnounds that swUUre Ls usetl to produce income, describe tha use and ponion
of the property ufilized b produce ixome.
CoaNy
I hereby ceAify the above statements are We, corred and complete.
slreet. cey, state. ZIP code)
County
1.
��5�^�'���������"` K�;�e�"���``TRUETAX� u. ASSESSEDVALUE 3'-HOMESTEAD} F NON=RESI�ENTIAL �
�.ea�.,. '�ASSESSOR USE ONLY ��� ±=� '� fi � �=��� "i VALUE'�' '�'����
.d.. ''_:eY�;K:ip.�$?`-4,"�''i: _. .�.,a�"`t�`:� 6g:. rw i��a VALUE;r���sy. :.AT 100%'OFiTfV� �:VALUE�. c.. ei .��.. ....aet"�'.`T'i k.`_
Land nol exceeding 1(one) acre immediatety '��* ,�-�f--�'-,."-.�� `�
surrounding residential improvements. (�) `_�� v�v Y r�. } �
-��* �.r.��,ru �..�r � �,::
Otherland (Z) t "���` �T'�`
.�.�-���.-�`�,�
Tdal land (line 1 plus line 2) (3�
Dwelling (4) �'r? .'��'�.,.�y�yz*`r� �;'�
�Residential improvements or Mnualty ' °`` � ���-� r"�`'�'-#"'����'�
AssessedMobile/ManufacNredHome Garage (5� �+"y�,�^''. �:'��`��"��
�..�., � ` r � ��
��r. a s_
.: yi_`a,�r,+-��:.
Otherimprovements (6) .��� ��sr '3-£�
'. � � -'��' �-`� � � � .3 �? s�
Rlal improvements (Irne 4 through line 6) ��)
Tolal value (line 3 plis line n (g�
I hereby cer6fy the above is We, corred, and Signature ott.�sessor Date signed
complete.
Verityimj aclrm - Signature oflwdiWr . Date sgned
Y�` ''�" � -'+ ''� s�'u��'��''�'""�'�vSTANDARU::DEDUCTION'ALLOWANCE4 �"i` �Y'� �" ` - T` ' '-
�".�: '.�.�.�. M �'.�,c��- �.:�.i#���:;u..u'r�Fas.���-s�`}����3.:�::.F
20_Pay20_
Lesierof 1�2 Homestead
va�uauon w 535.000 S
SynaWreoflwddw - Datesigned