Homestead_Seale0
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� CLAIM FOR HOMESTEAD PROPERTY TAX
- � � CREDIT/STANDARD DEDUCTION
� � State Fortn 5473 (RS / 10-Ot)
�°� Prescribed by ihe DeOartmem of Local Govemmem Finance
residence the following described real property for which a Homestead Property TrcLCr�ed j is her7e�bu daimed:
I(VJe) owned ❑ Are buying under coniract
� c 2
;Have a benefidal interest in Ne entity that is liable for ihe property taxes on the properry and that owns the prope��rty or is buyipg under a contcacL ,
If 6uy'u�g om m�tracl, Fee Simple ownefs name
Recorders office where contract is recorded
Taring
Rewrd number � Page
�/�� ��[J YV �0 � V � I��K` J`<� v� �l/ d-�-/Y /+' ihe PropeO�ReaISproPertY ❑ 6bbila HomoZfGbi. f-7)
I( any portion ol Iha resitlentlal sWCWre w the land not exceeding one (1) acre that immediatety wrrounds that sWCture is used lo produce income, describe Ne use and poNon
ot ihe properry utilizeA W produce income. �
�a'/ -/�'-D�- ,.3�a - �o�o �a - a�/
��a�'�'�.3�`;:`�`.='�k����l"+`� *� y��PROPERTKOWNED���BY�CLAIMANT.IN�:OTHER'COUNTIESa"'f�;!£�����,�T'�=i�5'�"t �-�+_-,':_r+ A �'�t
County Tavnship Couniy Township
I hereby certify lhe above statements are true, cortect and complele. Si ture o im t
'�ddress (num6er and sUeel, ci(y, stafe, ZIP code)
�R3 %�X /46A aw�.vsv� Ilc Zti �(76�5
�' ����'"'`����"�''���' '�'''��e'����� �s-TRUETAX , rs ASSESSED VALUE �HOMESTEAD'� `-�-� NON=RESIDENTIAL"�ii� -'�
a�'i��'�.�EX�a� �S'�'Ei��.A'�i_L�.Si.�:=iZ��:�� �";:'VALUE-,G��L � `AT.100�/e OFiTfV , �.1'=VAI.UE�r..�`` ��� s?"k;�?'VALUE i�,;,�_L�'�'rj E�
Land not exceeding 1(one) acre immediatey (�) ��.q{�v��,��� �,...r'� s y�_
suvoundin residentialim rovemenLS. _ -r �-�_ n ^"�:
9 P .s..�,._..`�A�:"^�..,..:rr
Otherland (p) F ��s�t"�`'+�,�� i' -
�? � rv:�_NI.I �:.si
Tdal land (line 1 plus line 2) (3) �
� r �� �'?�'f � � ' .r!
Dwelling (4) � � �. ,� � '`�',.�i''if3;
,.
Residenfial improvements �£""A"E��h�r`'' � '�''���'`
v. i' � ""` ��' -
Garage 5 xa c•<�ti'' �i+x'�'d�?
( J .�''i �. "'xb`��"' ��r�' "-.,.r �i w `",
...,i':'>Lny.i+YVT',;'+yT�±�
Other improvements (6) w; `�. S: �.:y�y`s > •
-=-..=rY.Y �.3 , �'-v�'t.'
To1a1 improvements (line 4 through line 6) (�) �
Tt1a1 value (line 3 phs line n (g)
1 hereby certify lhe above is We, cortect, and Signature o(nsseswr oate signea
complete.
Verifying adion - Sig�Wre oflwditor Dale signe0
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