Homestead_Schultz°'°. CLAIM FOR HOMESTEAD PROPERTY TAX � I YEAR
r>b-�- t CREDIT/STANDARD DEDUCTION � HCto �
` � �� StataFortn5473(R8l7-07)
Rescnbed by Ne Deparimerrt ot Local Gwemment Finance AU G
INSTRUCTIONS: See reverse side /or filing inaWcfions. �
. �
GIBS
� i'�e) � certify thal on the 7 s[ day oi March, 2b_
1(We) occupied as our prindpal place of residence the 1 wing described real property tor which a Homestead Property Tmc Credit is hereby daimed: ''�,
�(We) owned ❑ Are buying under contracl �I,
Have a benefidal interest in Ne en5ty ihat is 1ia61e for the property laxes on fhe property and that owns ihe property or is buying under a contract. I
If byin9 om m�Vact Fee Simple ownefs neme
Recorde/e oFfice where wrrtreQ is recorded I Record number Paga
Counry � Twnship � Tacing dis}rict,jcily, forvn,
Paicel number Legal tlescnption Is lhe prope u� queslion:
a� 1�-a 3�i ao -� . y�s -� a � P+ a3 3- i�. �i woverty ❑ Mobile Home (IC 6-7. i-�
If arry porlion of the residential structure w the land not exceeding one (7) acre Ihat immediately wrrounds ihat stnxlura is used lo produce inwme, describe Ihe use antl portion
o( Ne property utilized b produce inmme. _i •—r p�S
�C 0
�. � � . .� • �
i�.•
Land not exceedirg 1(one) aae immediately , - • ��
surroundirg residential improvements. (�� � . • � � �
OMer Wnd �2) � .
Tutal land (Irne 1 plus Irne 2) �g�
Dwelling (4) :...,� - �_
Residential improvements or Mnuaily
Assessed Mobile / Manufach�red H«ne ^ � -
Garage (5� 1: . -
�.
Other improvements (6) �
TUaI improvements (lrne 4 fhrough Gne 6) (7�
Total value (line 3 plusline n �g�
I hereby cerfify the above i5 We, correct, and SignaNre o/ASSessor Date signed (mmfh. day, year)
complete.
Vaifying actirn - SignaWra of Audibr pate signed (monN, day. yea�
�.-� � � • •
`— PaY 2 45.000 for 2007 pay 2008 42.000 for 2010 pay 2017
lesser of 12 qq.000 for 2008 pay 2009 41.000 for 2017 pay 2012
Homestead Valua6on $
w 43,000 for 2009 pay 2010 40,000 payable after 2072
SignaWra of Auditor Dale signed (mp�N, day, yea�
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