HomeMy WebLinkAboutHomestead_RexingCLAIM FOR HOMESTEAD PROPERTY TAX � YEAR
CREDIT/STANDARD DEDUCTION FORM
`� �` State Fam 5473 (RB 17-07) HC 10
Prescribed by Ua DepartmBrM1 ot Local Govemmant Finance
INS7RUCTIONS: See reverse side for fiiing insbuctions.
� �e� ', � t o tt�,lsld�V�March, 20_
I(We) occupied as our prindpal place resid e fdbwing described real property for which a H ste mperty Tac Credit is hereby daimed:
�1(We) owned ❑ Are buying under ntraG �uN � g Z008
' Have a berrefidal interest in the enCty tliat is liable fw the property ta�ces on Ihe property and that owns Ihe property or is buyjng under a contraG.
If huymq om m�iraci, Feg Simple ownels rmme
Racordefs offica where contrad is recortled
Counry Tawnship
Paicel number
If any porlion of Ihe residenlial sWCWre or
of Ihe propeity ulifizetl m produce inmme.
tlescnption �
/
na e%ceedi one (7
d�-� �-a 9-i� - oo /. 9y �-o a/
di5trict (Gty,
Ihe
surtounds that
Record number I Paqe
rtmqueSlion:
'�al Droperty ❑ Mobile Flome (IC 67.7-n
Yure is usetl to produce income, describe Ihe use and porGon
,_ , . . .. . .
„..
Land no� exceeding 1(one) acre irtmediatety �3 '– � �
surroundirgresidentialimprovements. (�) � , x �� �
1. i�,•;.:�_.: -
OMer Wnd (2� � _ _
;�.;
Tctal WrM (Irne 1 pfus lme � �3)
_ .,� u.5- , i. + -'
owenins (4) ' � ; .� ' "- . a�--. :
ResidentialimprovementsorMnualty �"� .s-, �-,_ ,
Assessed AAObile / ManufacWred Home � s� a. f� �,� -
Gawge �5) _ '. �.
.�,�. - '.{_'.
'cF . !,.�
Other improvements � (g) ='' `6 ;`-'s:�..:
Taal improvemenLS (I'me 4 through Urre 6) ���
TUaI value (line 3 pl�s lirre � �g)
I hereby certfy the abovB i5 We, torrect, arW Signature of 0.ssessor Date signetl (mwifh, day, yea�
complete.
Vaifyinp aclion - SipraWra oflwtlitw Dale signed (monN, day, yea�
� . . � � � � •
�Y Z� — 45.000 for 2007 pay 2008 42.000 for 2010 pay 2017
Lesser of 12 Qq.ppp for 2008 pay 2009 41.000 for 2011 pay 2012
Homestead Valuation $
« 43,000 for 2009 pay 2070 40,000 payable afler 2012
Signature of Audilor Date signed (monN. OaY Y��)