Homestead_Hurlock (2)CLAIM FOR HOMESTEAD PROPERTY TAX �.
:� I.:y � STANDARD / SUPPLEMENTAL DEDUCTION FORM
5'a:e Fortn 5193 (R15 / bta) HC70
�I P�eunMC Ey Ne Depa� ent o( loW Cawemr,cnl Fvwnce
INSTftUCTlONS: See reverse sde lor filing insfnxlans. �
NOTE: Telephone, Socia/ Secunty, tlrivers license, 9afe itlenti,5cafbn aixl /etle21 idenGfication numbers are confiden(ial under f. f ���
I(VJe) certity that i(we) ocwpied ayflSf ur
place of resitlence or am (are) buy g Ne following descnbed real operty under conVaa for which a Homestead Property Tax St.
DeducUOn is hereby daimed on the da.e this applica5on is signetl, (tlare o1 signatu 1(We):
[�Own. ❑ Am (are) buying under recorded conVad.
] Am (are) entitled ro occupy as a tenanFStockholder of a cooperalive housing wrporation. GIBSON COU�
❑ Have a beneficial interest in the wst or Ne right to ocwpy ihe property under the tertns of a qualified personal residence
❑ Am (are) the shareholder, partner, or member of the entiry ihat owns the property.
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n�m' Ca'�� d Ne msieen•.ial sJUawe n me IaM m e�teeG�mg orc (1) aae vut'vnmeau:eN su�muMe wt swGUre is �aea m C��a vm:ie. aesciee tne se am Dw',ion
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❑Yes�NO i
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I hereby certiy Ne above statements are true, mrtec[, and complete. ����� ��
Lantl ml aiceeding one (1) atra imm¢Liately
surtoanLinp resitlential imo�ovements
OtherlanE
Total land (lin¢ 1 plus line 2)
Rasitlentlal improvemenm or Dwelling
Annualty AssesseA Moblla I
Atanufacturetl Homa Wnge
Ofier impmvem¢ntt
Toql Improv¢m¢nts (/ine 4 Nrough line 67
Todl value (line Jplis llne n
I hereby certify Ne above is W¢, cortect,
anE compl¢te.
lm.jig atlion - 55��ure o� HMib�
(3)
(4)
(5)
(fi)
or rara;ed nomes:ew, a
20 _ pay 20 _ Lesser of 60% of Ihe assessed rdue of the homestead ar 545,000
AbMiMSfarM:ry any afherprovivon, Ne sum o/ Na deductbns provitletl in IC G f.1-f 2 ro a mobile home 5
lhaf i5 rwt assessetl as real property or fo a manu(acfuretl homelhal iS nol e55e55eC as realpropeM may
not erceetl one-haM (12) ol Me assesSeC value ol Ne moWe hwne w manulacturetl home.
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