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> - � t CREDIT/STANDARD DEDUCTION
` � ` Stale Fortn 5473 (R817-07)
Rescribed by Iha DeparMerri of Laal Gwernmeni Finance
/NSTRUCTIONS: See reverse side lor filing ins6uctions.
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AUG 0 7 2008
I(We) ��U� . ,7 (1/Y/1(R�/� certi Niat on th�%ist day�o'March, 20
I(VJe) occupied as our prindpal place of residence Ihe tollowing described real property tor which a Haneste���i���i��R��� daimed:
�I(VJe) owned ❑ Fve buying under mntraci
Have a benefiaal interest in the entity that is IiaWe fw ihe property taxes on fhe property and that owns the property or is buying under a oontract.
11 buying om m�Vaa, Fee Simple ownefs name
Recorder s affice where conUad is
Counry
Paicel number
IRewrd number I Page
1 (cdy, fo/µ��n �towyn�sh�ip)// � �
J.L, / �U //WL�/1 �
Iha Pro uYVUes6o
I'��7- 7/L. .JJ'J -/o� ///`-;
��ideMial siructure w ihe land nIX ezceediry one (7) aue that immediate�y surtounds U�at
� P�duce income.
�'G- ��-33 -�ao -va/.�� �a�-/
Real D�o�/lY U Mobile Fbme (fC E7J-n
ire is used lo prodtxe income, descnbe Ne use and portbn
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Counly Twvnship County Toanship
I hereby certify the above statemenls are true, correcl and complete. Signawre af daimam
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'ress (nuiberand slteeL criy-sfate, anC ZlPcoCe)' �
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Land not exc�ng i (orre) acre immediatety , ' -''��s ` -� ' • +:�' -
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surrounding residential improvements. �:R .:�, - ; :
Other land (y� - � �
Tdal land (Irne 1 plus line 2) �3�
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ResidentialimprovementswMnualy �n�� �4� y „Y � �t�" r ',
Assessed Mobile I ManufacWred Home _ ',t -'. .:<'--
Ga2ge �5� - � ' + � .
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Ofher improvements (6) . . � �
7ccal imprwements (line 4 through line 6) �7�
Tdal value (line 3 pl's line n (g�
I hereby certify the above is We, correct, and signawre otnssessor oa�e signed (montn, day, yea�
complete. �
Vaitying aclion - Signature otAudilw Dafe signed (monN. day, yea�
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2� _ pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2071
Lesser of i!2 qq,000 for 2008
Homestead Valuation PaY Z009 41,000 for 2011 pay 2012 $
w 43,000 for 2009 pay 2010 40,000 payable after 2012
SignaWra oflwditor Data signed (monlh, day, year)
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