HomeMy WebLinkAboutHomestead_Lincolna�' CLAIM FOR HOMESTEAD PROPERTY TAX FORm
4 STANDARD / SUPPLEMENTAL DEDUCTION Hc10
Sax Porm Sal3 (R15 / &14)
�! Presmbetlbytlie0epartmentc:LamlGovemmenlFinaze
INSTRUCTIONS: See 2verse vtle 1ar fiSng in9rtxtians. �
NO7£ THephaie, Sada/ Secunry, drivers Gcense, sfate itlenlificafion aritl letleral i0enlificalion num0ers are oon:ldentl�er� o-g i-
I(We) �/ G//Q E/ V T V/JQILY� L/NC Q/ f�/ certiry thaU (we) oauvied as mY (
place of residence or am (ar�g the following tlescnbed real property under contrea for which a Homesje��, PIro�rty
Deduction is hereby daimed o date Nis applicatlon is signed, (date ���ha ).
� Ovm. ❑ Am (are) buying under recorded wntract.
❑ Am (are) entitled to occupy as a tenant-stockholder of a cooperetive housing corporation.
❑ Have a benefdal interest in the Wst or Ne right to ocwpy the property under the tertns of a qualifi
❑ Am (are) the shareholder, partner, or member of the entiry that owns the property. (i18$�N O�IJNT
wmper �Pape
Par¢I numDU l a� �9 � Oesrsi �'� I ls U�e pope�Y �^ Gues•.ion:
I h•O •I-
Y� �/ ❑ aeai a�ocers ❑ nmuaN asxssed moeae nome U�
L• arry portm of Ne resilM.ial sTOUre w L�e IanC not exmeEing ore (1) ape Jut vnnMYety surrwnCS ita� Y.ntYUre b usetl to poCUCe im . e. � x me use ab
of Ce woxrY ^�d m P'�uce v�cort�e.
2�-��- 30 ��� �� � �y a o a�
I hereby certiry the above staremen5 are We, cortect, arW comple:e.
mnbtl (numoer erp 5reef, My, 5ate. aM
u
LanE not ¢xceedinn ona I71 acre
ONar IanO
Total Wntl (line 1 p/us lin¢ n
R¢sidantlal improvemants or
Mnwly Assessed Mobila I
ManufacwreE Home
5�� a,� ����
� R1
(3)
Dwe111nB (4)
Ganga I (5)
ONer Improvemen6
Total Improvements (lina d[hmugh line 6,
Todl value (line 3plis lina 7)
1 hereby certify N¢ above Is W e, correcS
and complete.
sgravre ctASSeswr
I Is ddimant varayg a homes:
❑ Yes ❑ No
m davnam � /J Q
LMQ[" `-' �/ f �n'Ll7L�
1 vanteE homesteaC, d a�ry � arW sGml, ay, re:e,
��Li,t '�76/�
20 _ pay 20 _ Lesser of 60% of Ne assessed value af Ne homes;ead or Sa5,000
NonwNStarM✓y any otheiprovision, fhe wm of fhe deducfions povitled in IC G1.;-1210 a moEila home 5
Naf is rrof assessed as real pmperty or ro a manufacturM home Nat a rrof assessetl as 2a1 propeM may
rrot ezceetl on�haH(1R) ol Ne essessetl vabe ollhe mobde home ermanutacfumtl hwne.
:ywyre aae-� or.e
DISiRIBUiION: Ugiwl-COUntyAW.�w.Fa S`ampeEGOpy-Taz,vyer
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