Homestead_DeJarnett rat,. •,wCLAIM FOR:HOMESTEAD:PROP.EFAi TAX r 'S e,,sa. •,a.•--- JsS YEgRs
r{ � STANDARD/SUPPLEMENTAL DEDUCTION .
Say Forth 5473(t17/1-16) HOW
Premr5ed Wive O Ls steal Goransoent Fear
INSTRUCTIONS:See averse side twang ihsbucEens. t - .
NOTE Telephone,Social Sec riy,drivers Ecease,state a5on and federal&attrition nu ben are cuitdeuiadefjt 5-1.1-12-37.I .r" -1 -
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CERTIFICATION STATEMENT
I Me) i%�i /, In �i - . . - ""e�ttiai 1.&:'0_,:`i :' _-.-1 •
• place of residence a am(are) - century is •-• (• •
( )buying the�e described real property.under contract tar which a H.,r._,�• :re 1.1.
Deduction is hereby claimed on the date thus appbcation is signed, • - • - r •- (date of signature). I(We).
ID Own. ❑ A m(are)buying under recaeed ctin[tact - '. : - DEC 1 9 2 017
❑ Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing oapo ation.-`
❑ Have a beneficial interest N the bust a the right to occupy the propeity under the terms of a,qualified personal residence trust
❑ Am(are)the shareholder,partner,or member of the entity that owns the property. '. , -e
Parcel number legal desoO'-on 00.00 '
- • tar 5€4) a.- 2,=-1 1 - ❑Red prcpety ❑Avuady assessed motes home(/C6-1.1-n
II any preen of to reuamts saudtse R em land not emrmg cos(1)axe that hmneclaey vngnds that=nee is used In prtIXCa Wane.describe lnd toe and paten . /
dun Progeny tared is pods from
fS
a Co.-// '.0A - • 300 - oo /., 6-G3 -- aa7 . . M
4�
- _ - PROPERTY OWNED ELSEWHERE BY,CLAIMANT :-
Sate,Candy,and Township • . v• Is daineit vacating a homestead?
a ❑.Yee•❑ No -
I hereby certify the above statarlfer9L5 am true,correct,and complete.
ofesdad(hwibermt tees(crN atse,atZlPmdr) ,_-. Address el _ -• In -a9 Punter and sheet,ay sr,eat ZIP *)
3115 G!./ /00 /A/ Ainctian Z„ s7/7670 - _ =.:3• - -- -, ..•
ASSESSOR USE ONLY t - ASSESSED VALUE ` i_ -HOMESTEAD VALUE .NON-R ALIUENTIAL
Land not exeeeding oar(1)sere Immediately ••y 1 --�_. -t: -iy...`• _ i�6 r;•
surround-mg residential improvements ( ) .. . . _ s.-�iZ.-:s
Other aed • (2) - Ss- xi'i tear•
Residential heprovemems or Dwelarag (4) .• - - t 4-t rr 's
annually assessed mobile l,. _ - 'e '•�
YS
manufactured home Garage (b) ._ Owakik
Other Improvements_ , (S) 7�,
� �£i� u!:. .. ..._r.:" -
Total hnpiovemerrb(line 4 through line u) (7) r
- ..
Total value;(/ire Spits foeA (a): •_
I hereby certlry the aboveis true,come. Siptare of Assessor r - pay signal(rrSi' dal;Seen
and complete.
Veiyb9 actin-Spna]ea of Amber .. 00-a s4nd Garret al yaar)-
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_� —. - -- ---. - STANDARD OEDUCTION'ALLOWAtJCE•'� �- �.0 -r�' l- , -
20 pay 20_ • Lesser of 6096 of"Oa assessed.
ssessedvdue o f the homestead_or$45000. ., - - 1- •
Notwt ngarty other trope*on,theman-of ms duredhors that is to 6-1.1-12 2 toarrobileNam $ • - -
that Is not assessed as real e assessed to a manufactured home drat is not assessed as real property may
not exceed one-/1al(1/2)of the a55GAed VaIM of the nubile home or manufactured home.
&Gears AseE •-, 1 1 .. . Data Signed(rsvfb.404?24
DtSURUUTICet Original.Careyaudta Ra9ai>ped Copy Tasprya • •. - i.
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