HomeMy WebLinkAboutHomestead_Martin (4)°' CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
` ' SUte Fortn 5473 (RB / 7-07)
Prescnbed by �he DepartmeM of Loral Govemment Finance
INSTRUCTIONS: See reosrse side /w filing insWc6ons.
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FEB 1 0 2009
I (we)�-� %%LG/e`7 j�iYi certiry m��g�p,PpJ6J�M�Y��13@�
1(We) ocwpied as our prindpai place of resid e Uie fdbwing described real propeAy fa which a Homestead Property Tac Credit is hereby daimed:
I(We) owned ❑ Are buying under contracl
Have a benefidal interest in Ne entity that is IiaWe fa the property taxes on the property and that owns fhe property or is buying under a contraG.
u aiy�p on c«,vaa. Fee Simpe ownere �ame
Recatlafs office where omNea is recortled
caunry
Pa� number
Tnrrnhip
description
dislriq (cify, to:m, totmship)
Is Ihe
Record number � Paga
If�i N!/J 3 O .3 / a. I ❑ R�� v(v6artr ❑ Mobile Fbme (IC 67 1-n
If arry portbn of Ure residential svucWre w Ue land na enceedirg orie (7 ) acre that immediatey surtounds Ihal stnicture is used W pmtluce income, descnbe Ihe use and portion
d ihe properry uliGrnd m produce inmme.
�6-�7- 30- /aa-oo/. 9oq_oa--1
Twrnship
I heRby certify NB ebov0 SfatEments aR INe, correcl and tomplBle.
(numberand sVeet aty, sfate, end ZIP
f��u�a I Gi �� -�f �
of dai
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Land not ex�rg 1 (orre) aae immediatey �- - --: �'�-: �- � - '=°'. � � .
surtoundingresidentialimprovements. ��) ,�,:�._.�..� , i._ _ .
Otlier land �p� ' :� tt �_;
Tdal Wnd (line 1 plus 1'me � �g)
�. � atir r�v.'�> 't��".�� i�,
Residential vnprovements orMnually �e�� (4) � . -�t-`'r _ �.. � `^:
Assessed Mobile / Man�red Home . v -
Garage (5) �?< _ - �
_5 � � '
♦ .�`y la ` ',
Other improvemenLS (5) ,. ,
yL,. .:3,__:x�,
TUaI improvements (line 4 through lirre 6) �7)
Tctal value (line 3 phs liire � �g�
I hereby Certi(y fhe ebove is true, corretl, and Signawra of Assessw Date signed (month, day, yea�
complete.
Vaifyinp adion - Sipnature of �mr Date signed (mmN. day yesA
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PaY 20 — 45,000 for 2007 pay 2008 42.000 for 2010 pay 2071
Lesser of 12 qq.ppp for 2008 pay 2009 41.000 for 2011 pay 2012
Homestead Valuation S
a d3,000 for 2009 pay 2010 40,000 payable after 2012
SignaWra of /wditor Date signed (manlh. daY. Y��