Homestead_WilcoxCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Slate Fwm 5473 (R8 / 4a1)
Presaibed by ihe DeOartment W Local Govemment Finance
INSTRUCTIONS: See reverse side lor �ling instruclions.
OR YEAR
� C10
SEP 2 4 2003
I �e) / V � � / , GI S '� h� Z�—
I(We) occupied as our principal place oi residence the following described real property for which a Homestea Property T�c Credit is hereby daimed:
❑ I(VJe) owned ❑ Fve buying under wntract
� Have a benefidal interest in the entity that is Aable for the property taxes on the property and that owns the property or is buying under a conVact.
11 bvying om m�tract, Fee Simple ownefs name
Retordars o16ce where conVacl is recoNed
Counb Tuvnship
Parcel number Leg escnption
�O� a� -�d ��-
N eny portion of Ne reaidentlal aUUCWre or the IanA not e�eeding one (1) aae
of the properry util¢eO b produce inwme.
sirri�viic
County
I hereby ceRify ihe above statemenLS are W e, corted and complete.
Pddra�r�¢,arM s�eet. cit�ta(e, Z/PCOde) . .
County
fownship)
Ihat suticture is useA
RecoM number
r
Page
❑ MoWle HOmo Q.C. &1J-�
� income, descrihe Ne uae and porUOn
rownsnip
�t�Y3:.�'4t"E''�" Pc'.��' 3ia�!'_.FJ'y�� � s`�ZS..'i - � `^„�S.�sie4..:-.. —o-..d...�.o� .y�.. . �
e�`rs'�- I�--. S9ESSOR USE'OV.N�iLY��`€��. :�Vtiy�e,.TRU uEF�.•�[{`�,g 9�A.ASTS �E�6(�a�./�� �(}iOk�EEA�sD� ��*4 N�EBfOECN��T1AL� .�� �
'i., a+�d�i55 �11�Y+_�! .+�Y�+��+4.aii.{+< i. f![�.tiw:.'._. ..i'G_el'� �.:.��.� ass.yiri..6� . {V!-���: ...ii}KY` L.. J.�.aJ':I.iriY�'�im�i�2�`+��,�.
Land not exceeding t(one) acre immediatery ;�'fi'�S#ti '±'` ��A"l4f-�" �'.
sunoundingresidentialimprovements. ��� °��y�,�'Y,^tjl,,'e�� ^s�,'.56�'t�:
'�st�
Other land �Z) '��r,�J��-�'e �
- , � -: � ;� '? ' � ". i?''' � ' . :
Tatal land (One 1 plus line 2) �3�
�4�,;}s:;'i��"�rZ.kt�'= #�.t� `h`:::�
Dwelling (4) `.-p'i+ �. �g� �'�'� :���?. ;4�»+w:3
Residential Improvemanta or MnuaOy }'`'�`A"'J`TPS'�'�`"`�'•":''�'°`
ASSeasBd MobHe / AlanufecWred Hane Gara9e 5 "'• �'P'ti•+; {� �Z�K�
( ) c��r��-�.,.
��:t• �:,:,�:a�is.:�.5�. �'L.tY'.a�:..;✓.{nS-'.`->*:
c._�K'�:.tJi.'�_s..
Other improvements (6) ni�i� �%ti::.=t�,yyi
-.L:.�t±c:. -
Tcial improvements (line 4 fhrough line 6) (�)
Tdal value (line 3 phs line n (g)
I hereby certify ihe above is We, cortect, and Signamra o�nssessor Date signed
complete.
Vpiitying action - SignaWre oflwditor Date signed