Homestead_Mayer,,`�R�� i CLAIM FOR HOMESTEAD PROPERTY TAX
- � CREDIT/STANDARD DEDUCTION
` J Sute Form 5473 (R5/ 10-01)
�°� Presai6ed by Ihe Depariment of local Govemment Finance
INSTRUCTIONS: See reverse side for liling insfmcfions.
T —�
YEAR '
FORM � — �
eio
J
I(We) i/�� ��`C.i�c�J `I` ��v // c i t at� 7st y of M ch,
I(We) occupied as our principal place of residence lhe follo g described real property (or wh" a Home ea,51�g'�q{Q �� edit � �y aimed
❑ I(We) owned ❑ Are buying under contracl
�iave a benefidal interest in the entity that is liable for the pmperty taxes on the pwperty and Ihat owns the property or is buying under a contract.
-enet�,.��e�.i�t`::�Y 'ry.:.''�-' r�'-i�.:�.'i ^•��`y.s�rCONTRACT'RECORDED_:-•_ ' -.�y
..ASVS: � 3 . ?7t}'Y3 . Y.h_.:3a' . :f.•. d • -
_ .. : -.. . _. . . . .z Y. . ." " "'. _ -
If buying on conlrad. Fee�Simple owners name . -
Remrdels offica where contraC is recorded Record number Page
Tavnship
Tacing di5lric�
P/3��ce�l ny`� ber `/ `/ '^� Legal tlescription Is the property In question: V
V`� J� T °�� T—v d �[�'eal property ❑ Mobile omo (I.G. 67.7-7)
I( any potlion of the resitlenGal st+uclure w Ne land not exceeding one (1) acre that immediately surtounds lhat swUUre is used to produce income, desaibe Ne use antl portion
ot ihe properry utiizetl to produce inwme.
County
'/O % /-OfUU�
k :?3',:.=:'-i-+'i.t.�a°=FROPEI
Toxnship
1 hereby certify the above statements are We, correct and complete.
streel, city, stafe, ZlPcode)
County
ot
�'��'`�z� �'F ����"`"`''� -`" '�+�� r-'�'��'�`�- -:.�yTRUETAX � < ASSESSEDVALUE HOMESTEAD�� �s � NON-RESIDENTIAL" ��-��
���i�� ASSESSORUSEONLY�Fi�r$i3,� ,;��VALUE'-, y �AT-100YeOF�TTV „R_�,.VALUE�„s-5�.. �`#q� _�i�.',VALUE'�`� -. �Sy,�.i'
s _+#.! Y�'�"..�:ar-�z 3�'}"'�
Land not exceeding 1(one) acre immediately M�:7t"r y�; "� �'� h� ��� �.��^, :.:
suvounding residential improvemenls. �� � '- � `,'�,��,. �� �,,,, ,,;�'' x-?� ;.`� �.
��:b�3Y+a >.f; �
Oiher land p '� . � �•Tr�' �f �i
( ) �,;'�7>e.�'.. -,::�s'.�
Tctal land (line 1 plus line 2) �3)
Dwelling (4) ��.;xit+�3M-�'t���1:L'c��4'7c-�;.
Residential improvemenls '= ' "� �.kr �.� `bi'-'+"�`cFS 3
Gara e '�-�ma'k��`m�'y`,��s�" r�,i;.
9 (5) ��' �'si °w,,,:: 'r �:�'' ." s,.
`Y'�1:1:.� :.i .�� �'i"Y"�IS� ... r>3°i..: . _
�;� �>y
Other improvemenis (6) 4� � � � �.-Y��>;;
_ �.: +: � , �:.*.ii =,�'. t.: � r 'n s; . �..
Tolal improvements (line 4 through line 6) (7)
Total value (line 3 phs line n (g)
I hereby certi(y Ute above is Uue, corted, and Sgnamre of.'.sseswr Date signed
comptete.
Vrrilyin9 aclion - SignaW re of N�tlitor Date signed
20_Pay20_
Lesser of 1l2 Homestead
VaJqation or 56,000
3
Date signed