Homestead_Schwartzlose (4)S"'" CLAIM POR HOMESTEAD PROPERTY TAX
i — : STANDARD / SUPPLEMENTAL DEDUCTION
State Fortn 5473 (R12 / 6O9)
�' t` Presaibed bY �e Deparimant of Local Govemment Fmnce
INSTRUCTIONS: See raverse side for filing insfnicfions.
C
MAR 0 9 20
�o�•"
I(N/e) Y . cerliy Nat I(we) ocw�p�l�edT as
place ot residence or am (are) buying the following described reai p rry tor which a Homestead Property T�'io���r�iimldloYn i
under conVaG on ihe date Ihis application is filetl, (date of filing):
❑ I(We) own ❑ Am (are) 6uying under recarded conVact
❑ Am (are) entilled to occupy as a tenant-stockholder of a cooperative housing corporetion
� Have a beneficial interest in ihe trust or Ihe right to occupy the property under Ihe tertns o( a qualified personal residence Wst
Name of tlainum (kga name)
�� �
Sadal Securiry number of tlairtanPS spouse (last frve di
tlbirying��raMr� FeeSimple e nama /
/�P j�l
RemNers tfice wl ere c q is reco�d tl
Cq��(y� / � Tovmship
� �� —003�a-
F / /
Caunry
onrers i�cense i ie�,�oc
or aa�mam �wn rnre e;yvs�
�maYS I�cense / Itlnntifrafion / p0�gr number
of daimant's spouse (/asf five digits)
aa.
.�. o.r� o� �'
townshiA)
desai0tion Is the GroPenY in puestion:
� Realpioperry �
nol exceeding ane (1) acra Nai immedlatety surtourMS ihat sWCWra is used m
I hereby certify the above statements are We, correct and complele.
�Pddmss(�wm6erandsfree(. stare. Z co
�D'7i YJ I.�D �� 0 �
Land not ezceeding 1(one) acre immediatety
sunoundin residential im rovements.
Other lantl '
7otal land (line 1 plus line n
Residentlal improvements or Mnually �����9
0.ssessed Mo6ile / Manufactured Home Garage
Other improvemenu
Tofal Improvements (llne 4 Nrough line b�
Tofal value (line J plus Iine � �
I herehy certify the above is true, cortect,
and complete.
Vaifyiig atlion - SynaNre o(AUditor \
�
n)
iz)
(3)
(4)
(5)
(6)
181
sg�m� or ���
Counry
20 pay 20 _ Lesser o( 60% of the assessed value of the homestead or 545,000
NoM4�standing eny aMerprovision, the sum ol fhe deductibns provided in /C 61./-72 ro a rtwbde frome Nat ic 5
rot assessed es real properry or fo a menufafturetl home Nal is not essessed as real piopeM maY rof erceed
wleJiatt (7I1) W fhe assessetl vdlue M Me rtabile home or manutauured hortie.
gnaWreNAUditar n
J
Iswing S1a;e
H� �- fis/i,�
Rernrd number ' Page
.'S li —/ ,
� 1
assessed
Township
home (IC &t.
Date signed (rsmnfh. daY, Y��
Date 5i9neE (manth, daY. YeaA
•
Dete v9ne0 (monN, day, yea�