HomeMy WebLinkAboutHomestead_Thomas (4);d�' CLAIM FOR HOMESTEAD PROPERTY TAX � YEAR
= STANDARD I SUPPLEMENTAL DEDUCTION FoRm
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'•' Presuibed py Ns peparGr,ent N Lool GcvemncM F rtc
�N$T{$�JCJ/�$: $QElEVElSB SIdB �O(:111lNfIlISfNLllO/15.
NOTE: Te/ephone, Soda/ Secunty, driver'Slicense. sta:e idenli;r.aubn arM7etlelal itlenGficefion numbers ere mnfCenlial vnder+C6.L 412-3L
I(We) d� �"'""'� �� ,�,LR�O�YV--l4� certify that I(We) occu�ied aslh�yjbutypr�a°al _
place of residence or am (are) buying ihe following descnbed real property under contract for which a HomestPad Pmperty Tax Standard
Deduction is hereby daimed on the da;e this applica6on is signed, (date o7signatuoli I QNg�1: �O�C
IV V j tf J
❑ O�m. ❑ Am (are) buying under recorded wntract. .
❑ Am (are) enti;led to owupy as a tenant-stockholder of a cooperative housing corporation. /�� �
❑ Have a beneficial interest in the Wst or the right to ocwpy the property under the tertns of a qualified persQp�({� iC
❑ Am (are) the shareholder, partner, or member of the entiry ihat ovms the property. �;,,,,,��`�!'��
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m
Paeal num0er I Lega�,ion�� ��� � I Is ine pope .ry in Ques�on: ..
❑Ramnocenr ❑aN,whzssesseamoaxmmeOCG�.�-]�
C aM O�m M Ne rtiEeeeul s7urvne or:'Me IarE not exreeCUN me (t) ave Wt vrtmMa:M' wrtaunCS inat s'.�uGUre e:aM b G�uz inm�ne. GesmCe :ne use aed W�'•»n
m tne �oxr:Y �Gi¢M to aoCUx'umne. ..
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Sa:q Ca.rtGy. antl TownsNo
I hereby certify ihe above statements are Vue, cortect, and comple;e.
garess ot con;ad (numDererM shee4 crty. rero. eMZIP mCe)
Land
OtherWntl
Total Wntl (lina 1 plus lina �
Residentlai Improv¢m¢nb or
Annualty Assessetl Mobila /
Manutacwred Home
immetliatery
Dwelling
Ga2ge
ON¢r improvem¢nts
Total improvem¢nts (lina d(hrough line 6j
Total value Qine Jpl�a lln¢ 7)
I hereby certity the above is We, correc4
antl completa.
�a 1vn aaim - Sarev:e dPUal:w
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20 _ pay 20 _ Lesser of 60% of the assessed wGUe of Ne homes:eatl or 545,000
Non�ifhstarMing any ofherproHSion, the sum o7fhe deducfions provi0etl in IG Gf.1-f2 fo a rzrobile home 5
lhat is nof assessetl as real properry or ro e manNaGUretl hane Naf is rrof assesseC as real pmperry may
�rol e+ceetl one-half (12f O7IhB assessetl velue oI fhe modle M�me wmanNaUU�eC Mme.
DISTRI91fItON: Uginal-COUn.yAUEi:or,Fie�SampeOCopy-iaa{nyer
C1d1(Ildfll YdtlilfA] d
❑ Yes ❑ No
ana svaec �r.
Da:e s4� (rnvv�n. GaY.Y�)