Homestead_SwanCLAIM FOR HOMESTEAD PROPERTY TAX FORM Y�
-•._^_-�{? STANDARD / SUPPLEMENTAL DEDUCTION Hc7o I �p
i� SateFOrmX]3�R15/S1a)
�r+ PresmpetlbytlieDepaf.memolLwalGw .mentFra`x.e '
INSTRUCTIONS: See reverse side lorfilirglnstruc(ians.
NOTE: Telep/rona, Sadal Secunry, drivefs Lcense, sta.e idenli;icaubn arM (etla21 i0enlilkalian numbers ere confi0enlial �nCe�gy /-f 2-7�� F
1(VJe) - l certify that I(�) occ�iefAac/n�{eetj pf
piace o' esidence or am (are) buy the follovring tlescnbed real property under con',raq for which a Homes.ead Property Ta�c SL
Dedu n is hereby Uaimed on th date this applicatlon is signed, (date p(�qaf{ye1 YfYYfII
NUV !i4 [uw
❑ Am (are) buying under recortled contraa.
Am (are) entitled to occupy as a tenant-srockholder of a coopereMe housing corporation.
❑ Have a beneficial interest in Ne trust or the right to occupy Ne property under Ne tertns of a qualified n
❑ Am (are) the shareholder, partner, or member of ffie entiry ihat owns the propeny. __„_,T, ��
��
�
3t
Remtlefs o5s wliere mn:raa is re�ixtleE
Partd n�mGc
roNOn ot ine resqenW � zhvaure w ine Wm rot eareeaag ore (t) aae cwt
C�G�rY V.daM ro C�a%um'u1[ane.
a�-ra-v�- aoo
�.. .
Recortl nunEer
Is U�e yoperty N Quesfwn: / �
��acarr ❑r�rnuMzuesseemcaxnw,e�icFt�-n
r
ia:ey w�mu ihat sVUCWre is useC m proauce vmme, aesrnoe ure use ana i.ion
oo�f. ��q-oa�
tlaimant vara5n9 a
❑ Yes ❑ No
I hereby certiy the above sta:emenis are we, cortect, and complete.
daiess of mrcac (rwm0e� aM sVeet �Y. gaM, ark LP�
LanE not exceetling one (1) acre immatliatety
surrounCinq residenGai improvemenb
Otherlantl
Topl lantl (line f plus line 2)
Residential improvemenb or Dvrel�ng
AnnualN Assessatl Mobila 1
Manufachued Homa Gaaga
Oth¢r imOrovemenb
Total improvemenb (lina I Nmvgh line 6)
Todivalue (line3pl�aline7)
I hereby certity the above is We, co�rect,
antl complete.
IaJ�'v�g aniw - signaWre o(Ndeor
(1)
12)
(3)
(4)
(5)
(6)
(7)
(8)
5gfuaue NASSessar
davna�4 .
20 _ pay 20 _ Lesser ot 60% ot the assessed �rJUe ot the homes'�eatl or 545,000
Nolwithsarrding any oNe�proWSion, fhe sum o/ lhe tletlucfions provide0 in /C 67. 7-/2 to a mobile home 5
Nat is not assessetl es 2al pmperry or ro a manu;aclurad home Naf is rrol assessad as real ploperty may
not esceaE one-hall (12) oi Ne assessed value o7 Ne moDde home w manW.arlured hwne.
�0^ay�,�..4<°� C� � /
wsrweurror+: o:y;ui-c.:,mrnw::ocFe�sa�,c�wco%-ramar«
stae.