Homestead_Mattingly� R�3
e� g CLAIM FOR HOMESTEAD PROPERTY TAX .
;;��: CREDIT/STANDARD DEDUCTION '
...��:;;� SlateFOrm5a73(R2/5-92)
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INSTRUCTIONS: See reverse side /or filing instructions.
FORM YEAR
HC70
� � - � CERTIFICATION 57A7EMENT = - � � . _ .
I IWe) , cerp/gp��p� e rch, 79
�) occupi as our ri cipal ce of residence the follovring des i d I property for which a�HOmesteap�qr��� 't i h by daimed:
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❑ I(We) ow ed ❑ Are buying under contract � - - �y n 7
❑ Have a beneticial interesi in the entiry thai is liable for the pmperty taxes on the property and that owns the p�pViyyu Ib b�� under a contract.
� • - � � - . - CONTRACT RECORDED . ` � _e� .� �� - , � '�
If buying on contract,.Fee Simple owner'sname . � - . -/.'� `;��� � �'�UN?Y k'JC1?0=: . -
County - . . ' 7`ow ip - -
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PaOCe� ur�yber� � _/� Legal description
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It any ponion ot ihe residential structure or the land not exceeding one (7) aae that
oi the pmperty utilized to protluce income.
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Rewrd number � Page
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surmunds that strucmre is used to produce inCOme. describe the use and
10�
PROPERTY OWNED BV CLAIMANT IN OTHER COUNTIES �
County Township Caunry Township
Certif 5tatemenls are true, CorreCt and Complete. Signature of claimant
' Ad ress u a ds eel. ty, �afe.ZlPCnde)
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ASSESSOR USE ONLY . TRUETAX ASSESSED HOMESTEAD- NON-RESIDENTIAL.
VALUE VALUE VALUE � VALUE
Land noi exceeding 1(one) acre immediately
surrounding residential impmvemenis. (�) ��'
Oiherland (p) -
Total land Qine 7 plus line 2� (3�
Dwelling (4)
Residential improvements .
Garage (5)
Oiher improvemenis (6)
Total improvements (line 4 thiough line � (7)
Total value (line 3 p�s line 7� (g)
I hereby certi�y the abOVe is Irue, COrtect, and SignaNre of Assessor Date signed .
complete.
�"ving action - Signature ot Auditor Dare signed