Homestead_TurnerCLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
Stete Fpm 5173 (R6 / 1-03)
PreaaiDed by tlro Depamrrorrt d Lxsl Grnromrtbnt Finaxe
�NSrnucnoNS: s� �� araa a,�q �u�na
FORM
HC10
-zcn
J
YEAR
I(We) ,/ certify ihat on the 1st day of March, 20_
I(We) occupied as prindpal place of residence the (ollowing descnbed real property for which a Homestead Property Tac Credi� is hereby daimed:
❑ I(We) owned ❑ fve buying under contract
' Have a benefidal interesl in the entity ihat is liable far ihe property taxes on the pmperty and that owns the property or is buying under a wntraU.
If buying rn coniract, Fee Simple owners name
Recofders ofice where conirad is remrdeA
Counry
N any
of the
�
Counly
Tamship
the
v i oi -�— i�j ac_ 7' � /- d%d I
resitlential sWcWre or the land nd exceeding one (1) aae tha� immcWiatey wrrounds Ih
e0 tn produce i�ome. / �
�0
_ /?-o�
- �a� ��
EDl BY�CLAIAAAN'T; IN i07
Couniy
I hereby certify the above statements are W e, corted and oomplele.
sfa(e,
Record number � Page
Real property{� ❑ Mobile Homa (I.C. 6f.7-7)
ue is used to ptlroduce inwme, desaibe Ne use and portion
Toxnship
`x r,��7�`�-.�'_'�" a ,. �....., g„ y..:..,. u, -
� � $�s`�KVASSES50f��R�U��S NL�_Y � �UETAX�� ASSESSED V/1L.UE �HOMESTEA�� � � NON RESIDENTIAL �
;F-' . ��y,�,v^«�#g�,� �5����'•'�°%VALUE�j�'"l` �AT700%yOF.T�yT/r,� �VALUE�� �����'�..�VALUE�"�Rka;���'�•,
Land nol exceeding 7(one) acre immediately ��'a �-_#'°�' gr�'E*zy�
surrounding residentlal improvements. ��� a�'�,. �"� " �t' �: '� �
v..� ��r_."kGa+�� �<s'?�Fa{r�.°L
Otherland `�`�`'' � F.i'' Y �
�2) a���
�
_'..�a�.: �.�ai
Tdal land (line 1 plus line 2) (g)
%�� ''=�4� �s�,a..��
Dwelling (4) ������'�3%��,.� � �
R� fA�e vemen�nHuaOy� Gara e '' � `'��a.'�� �'
9 (5) ���£��� z �. � s-` .t �
Other improvements (6) �����
����
Lza a.
TUaI improvements (line 4 fhrough line 6) (7�
TUaI value (line 3 phs line 7) �g�
I hereby certify ihe above is We, coned, and Signamre otnssessor �ate signed
complele.
Verifyi�xj action - Signature oflwdiWr Date signed
�'�*�`��:'��r ��'. e�x�T?i�"'�+"z�'�r�`a`r�.°''s'a"`�.�',„�--�STANDARU'.DEDUCTIONALLOWAHCE: w.�s�.e:�.��ta!'���s-�'t +�a'�e�i+-��?�.4�'hF':��
20_Pay20_
Lesserof 1/2 Homes;ead
vawaLOn or 535.000 $
Signawe of Audila " Date signed