HomeMy WebLinkAboutHomestead_Bolden CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
ty r.� STANDARD/SUPPLEMENTAL DEDUCTION FORM
Sale Form 5473(8151 S-14)
'Z' Presoibed by the Department of Loral Goverment F Wnce
INSTRUCTIONS:See reverse side for filing instructions ,.
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NOTE:Telephone,Soda/Saco*drivers license,state identification and federal identification numbers am con fderunnli t f�)� . s .
-°.-';: T i-(!it - - ` . ?.,i:_'CERTIFICATION STATEMENT' `r' ' <`�^.•- • ^°..r'?.t._.- (.�°' ,
--I(We) \`mile ~•�'>i r certify that I(we)o Rd$m)?DOA•rindpal
place of residence or am 7L7 - buying following described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date 1 s application is signed, (date signature. I el-
❑ Own. ❑ Am(are)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.GIBRWN COUNTY AUDITOF�
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a quit ed personal residence trust
❑ Am(are)the shareholder, partner, or member of the entity that owns the property
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If buyig on contact.Fee Simple owners name
Reader's o5ce where contact 4 recorded
cor Read number I Page
:a`N s� } 3'1_eil%_,A`2(it'l 9„"Ca 2PROPERTV,DESCRIP.TION'-'s�`nniKeP e
1 Township 1 Taal?tact(city,tow).townshh)
-arW number Legal desaipm Is the property in n
questa
(0-1 s15' aoa-kcal 3 a o-oc �y Real poppet/ ❑ Annual),assessed motile home(rC 6-1.1-7)
If any portion of the residential=nice or the land not exceedarg we(1)acre that imxdately that 4N:Me is used to produce inane.describe the use and portion
of the property halted to produce inane. •
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PROPERTY OWNED ELSEWHERE BY CLAIMANR
State,Cary,and Tcwnsigp Is claimant vacating a homestead?
. • ❑ Yes ❑ No
I hereby certify the above statements are true,correct,and complete.
Address of contact(number and street,city date,and ZIP code) Address ad cad,L any(number and street,coy,stele,and ZIP code)
IPI1. __ x. ( • e . zN
ASSESSOR USE ONLY , II ASSESSED VALUE - I. HOMESTEAD VALUE I. - NON VEASIIDENTIAL•
Land not exceeding one(1)acre Immediately !�
surroundingresidentialimprovements (1) d .r Se pL_,._.,_-
r
Other land (2)
Total land(line I plus line 2) (3) - _ __. _
Residential Improvements or Dwelling (4) ,": y `.t'''C-':-:.
Annually Assessed Mobile l --- -Manufactured Home Garage (5) ' , ---zr
Other improvements (6) - t ..
Total improvement(line 4 through line 6) (7)
Total value (line]pits line 7) (8)
I hereby certify the above Ls true,correct, Signature of Assessor Date signed(month,day year)
and complete.
Vaiyfig adorn-Signet:re of AUM:or Date signed(month,day year)
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