Mobile Home_Ankney la gt44 - --``_ CLAIM FOR HOMESTEAD PROPERTY TAX '<RM 1' `� YEAR .4 CREDIT/STANDARD DEDUCTION HC10 �// V- -j State Form 5473(R5/10-01) ritni Prescribed by the Department of Local Government Finance INSTRUCTIONS:See reverse side for filing instructions. -T71 Tr- p' - st% ' -a'"t, ,-�`;.--I --CE-k FICATION STATEMENT`� 2 ;"' '•,,4fl I(We) i U�_ Iry certify that on the 1st day of M54,-21! I(W ccupied as our principal place of residence the following describe.- property for which a Homestead Property jhcjeaiit v htrabytdaimed: I(We)owned ❑ Are buying under contract ///' /�/L7UUL ri Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or ying untie r ��ac9 .... �iF. .JY?`rE�'r ''..`cre{:',y :Vt-•��"-1,e, i..-..F4'Te Ste •<CON TRACT.;RECORDED?^;f,` CE C4v#.. :z'_ :r r- 7_ :i=t.4, Y : . If buying on contract,Fee Simple owners name Recorders office where contract is recorded Record number Page �-5.7t{ .`4'd[`.{ ,:.M F ,t'rs.jc'! ; linktM PROP,ERT.YcDESCRIPTION! 4;.?-i'. E`fli-< .` C..:1=.w.c :its,':'TZ5-":1 ,. County Tavnship •c -• Taxing d 1(� con,town ip) /0tir, O W x / U egal description Is the property in question: ❑ Real property ile Home(LC.61.1-7) If a to / Mob ion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is used to produce income,describe the use and portion of the property utilized to produce income. e / ! 9' et /- A-u13 Ift'? a` :,W54--i .S is'?1S7 -0x `e"!u OROPERTYOWNED.BY CLAIMANT IN:OTNEW000NTIES -i - fn°;., A%-rtaNtz'°" 1; County Toxnship County amass, ______ I hereby certify the above statements are true,correct and complete. Sign ure of claimant Address(number and street state,ZIPcode) tit r / / f 54-. 7Z.31 "=*`"'> i"-ri+'$$rL`,, -t3'^ �2. -' ` - ; ckst}y. 4;!. `�TRUETAX ='4 ASSESSEDVALUE 'HOMESTEAD'- NON-RESIDENTIAL ��-'�- .F ASSESSOR USE ONLY T-:,. i ?mot S/i x 3- a: vim" 1� i. hX:;.t - lVALUEk' ..,,a :AT:100W0F,Tr VALUE!'s : hiv (44• ":,VALUE°_ �x j1 .! Land not exceeding 1 (one)acre immediately '7 "7 f 4 `r � s A-�i`C+ri surrounding residential improvements. (1) 7 ` „ _ < 4R1 -r fi ?, v .T Other land (2) -i t.xs ..- . rw_-._ter Total land(line 1 plus line 2) (3) ;A r r i sd°l? fLDwelling (4) ' ' ';;4 ' r 1 o1c{sui : z -ai. . .Residential improvements - t Y RS .. Garage (5) gi7 f ' , Other improvements (6) e -∎ 1117:44 Trial improvements(line 4 through line 6) (7) Total value (line 3 ohs line 7) (6) I hereby certify the above is true,correct,and Signature of Assessor Date signed complete. Verifying action-Signature of Auditor Date signed �l `y`s-,t'; y *rav.W—a :.=,-"x# ,.' �tJ,'y`':.:STANDARU'.DEDUCTION'ALL'OWANCE .x,.>:x.::x's,'V'. .`y ,C—fueg,` re__ ?k `,l1W,' 20 Pay 20 1(� /� ^�\\ Lesser of 112 Homestead " fl/ S\I\S) :W\ Valuation or 56,000 \ 1S- Signature of Auditor Date signed