Homestead_Murrayi
' CLAIM FOR HOMESTEAD PROPERTY TAX FORM YE�
•_ � STANDARD/SUPPLEMENTALDEDUCTION I
StYx Fwm Sa]3 (Po5l S1a) HC70
��' PrtsaiEeEGY��Pa�mtotLnralGOVem�neniFi.wnre I
INSTRUCTIOMS: See reverse Side (or fi6rg in5fruclions
NOTE: Telephrne, Social Secunry, tlriver's license, sfate itlenfi�icaGOn arM /etle21 itlenfi('icafion num6ers ara mnfitlenual uMer IC Sf. f42-3�.
I(We) '� certify that I(we) occupied stny ur nnci
place of residence or am (are) buying Ne following descnbed real properry und con•.ract for which a Homes.ead pe � d'
Deduction is hereby daimed on ihe date this application is signed, (date of signatu2). I(We): I._
�Own. � Am (are) buying under recorded conVad. OCT 3 O C
❑ Am (are) enSUed ro occupy as a tenan4s:ockholder of a cooperaWe housing corporetioa '
❑ Have a beneficial interest in the trvst or the nghi to occupy the property under the terms of a qualified personal r ence trust.
❑ Am (are) Ne shareholder, partner, or member of the entiry ihat owns the property. �jp�
/ " I Gl ►^ ra
c( tla'u:ant (lesf (rve d'gas)
apwse (last fiw dryh)
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NlmIEC(S O�V! W11E(G Wfl'J2C 19!!COlEp�
numbc � Page
Pae�l numErr �egai cesmpJOn I Is yu properry in pues:ion:
��
i/ /_ '1 �f,�7 -/O �(� fteal MoPMY ❑ Pmua%msezseE rtwNe Mme N
/1 l/l / 7G
tl a�ry pof.irn ot Ne resqM.ial z•,NGUre or Ure IaM � e�teeCVq me (t) ace Vat L^�.'�Mjlely� � t stNQUre ia useE b proCUOe uf�me. EesaiOe Ne use anE
of dx MW�'Y vTaM to 0�-'um income. � OC J
01-�o-/a-a-7 _�o / a�a/ 8'y � oa�
Is da'unant rarating a
❑Yes ❑No
I hereby certify the above statements are We, mrrect, a� comple:e.
OMer land
Todl land (���e � plus line 1)
ResiEantial improvemen¢ or
Annualty Asz¢ssetl Mobila /
Manu6cNreE Home
5ab,
Dwelling
Garage
Other Improv¢ments
Total lmprovemenb (line d Nrough line 6)
Total value (line J pl�s line ])
I hereby certify ihe aEave is vue, corz¢c4
antl complete.
laJyvg aCbn - Siyvwre o(Aiw:or
(1)
(2)
(5)
(6)
(7)
l81
20 _ pay 20 _ lesser of 60% of Ihe assesseC valu_ of Ihe Mmestead w 545,000
AbnriNSaMirq any ofherpmvision. Me sum ol fhe tleducfions providetl in IC 6 f.l-f 2 ro a mobile hwne 5
Naf is nof assessed as 2alpmperty w lo a manufacturetl home thaf is nof essessetl as real propeM may
rat ezceetl wre-haM (12J of fhe essessetl value d Na moD7e home w manufacmretl home.
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DISTWBUiION: On9w1- Cout.ryAWCar. FieSa..pN Copy-TaCayer
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