HomeMy WebLinkAboutHomestead_Scott (2)CLAIM FOR HOMESTEAD PROPERTY 7AX
� CREDIT/STANDARD DEDUCTION
♦ � Slate Fwm 5473 (R6 /!-03;
Prescribed �y the Departmem ot local Govemment Finan�e
INSTRUCTIONS: See ievcrsc sidc !nr lilinq inslmc(ions.
. f _
FORM �, YEAR
HC10 �
— � - ?� ^ '�' �- " �•�' "" :-CERTIFICATION STAiEMENT"'- - �
:#.+ . _ - � - � .. . .. ..
��e) rtify that on the 1st day of March, 20_
I(We) occ ied as our princi I place of residence the tollowing described real property or which a H mestead Property T�c Credit is hereby daimed:
I(We) owned ❑ Are buying under contract
� Have a benefidal interes� in lhe entity that is liable (or the property taxes oo the properry and that owns the property or is buying under a contract.
If buying on contracl, Fee Simple ownefs name
RemrOefs o%ce where wntrad is recorAed
Counry
Parcel number
� ��t
Ii 211Y pOf�1M OI �i1B f851
ot the pmpeny uWi2ed to
Rewrd numDer
Page
''�' � -�`'.'. �-"'�-� PROPERTY DESCRIPTION-=:,^ � . _ � . .^ �" -'s �^ ° - . .
Toanship T�i di5trict (city, fown, rownship)
Le 1 s�pUon Is the pmperty in question:
� � roperty ❑ Mobile Homo Q.C. 61. f-7)
dential sWCture w the Wnd not exceeding one (7) acre lhat immedialety surtounds Ihat swcture is used lo produce inwme. desuibe �ha use and portion
produca intAme. _ '1 ¢n�'
'J! UL/
-/� o�/GO-c�-�,Ta���/
���� �>' ASSESSOR SEONLY- : TRUETA7C ASSESSEDVALUE � HOMESTEAO•"' NON-RESIDENTIAC, �
. _,
Y .<-.ry^t s t � � .� �,. r.. `,•• . '� �.'` VALUE ' � "AT 700%`OE:TTV: �.. `VALUE':'s: . r.: .: �•.c_• VALUE-�. _
a9c=i5Y ,1..1..1...:....... _<..d.�v. .. �••� .• •
Land not exceeding 1(one) acre immediately ��'. ..
surrounding resitlential improvements. (�� _ . ..
Otherland (2) •� _, .
Total land (line 1 plus line 2) (g�
Dwelling (4) � .:,• . � v `
Residentiel improvements or Mnualy
Assessad Mobile I ManuFacNred Home Garage �g� .`E A� �-.:` ' �� .�
Other improvements (6) �
Taal improvements (line 4 through /ine 6) �7� � �
Tctal value (line 3 pl�s line n (g�
i hereby cetlify the above is We, cortect, and Signature o�ASSessor oate signed
camplete.
Vrriying action - SignaWre of Fwditor Date sgned
.fir.Si-'�;'- _ i� ;3. ='=5T/WDARD.DEDUCTIONALLOWANCE"'�' - - `� � � �- � �?�� _"�
20_Pay20_
Lesser of 1/2 Homes;ead
vauamn or 535.000
5
SgnaWre otlwditor ' � I Da�e signed
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