Mobile Home_Armstrong CA.\
u YEAR I
CLAIM FOR HOMESTEAD PROPERTY TAX FORM -
ll CREDIT/STANDARD DEDUCTION HC10
1/4,..,:,' State Fonn 5473(R6/4-03) l S.
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. 1
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eggtir t L_-:._r `,t-i' j /.27/ :t tg �/�1w�'El'e. : -TIFICATIONS •TEMENT'.. st •'- a: - t W•1 N..- .
I(We) �j/' I " r `-r i,id diAth _ _a certify that on the(FSf tlayk9f blarrthr21
I(We)occupied as our principal place of residence the following described real property for h a Homestead Property Tax Credit is heereby claimed:
❑ I(We)owned ❑ Are buying under contract / �e
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Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the propelty&or l lying under a contract.
3 s'I SGN COUNTY ailnir.,y
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�'��.�x..`�`4.�.4ir�,�:'�.,` '�'. _s`-�' ?Jdr '�?�,`.'Pr�.'�•CONTRACT.�RECORDED..: Ci:.q-4W;'*'..t* 'xWSc`mss. MM-itW..;.
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number Page
w- '# muter larigT • +letl PROP,ERTY bESCRini0N:K.. `:t{ . .t!?u+'.'i`tt'. ` f '-'y.r: °<._ y.K:'
Township 'racing district(city tow�)to lci Car � I� -`I
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Parcel C t /( Legal description Is the property in question:
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0 Real property Mobile Home(LC.6-1.1-0)
If any portion 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.
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a l-Av12 (o. 9oo/F-06 If
a 'tTif"? " fti&`e`PROP.ERTX.OWNEDBY CLAimAii -IN`OTHER'COUNTIES, :K ige flf: G ''#',^Nvy!;
County Township County Township
I hereby certify the above statements are true,correct and complete. Signatu .f claimant t
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stress(number and street,city,state,ZIP code)
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3� -k'/�- ASSESSOR USE ONLY '�4��' �E TRUE TAXI ASSESSED VALUE +HOMESTEAD� ?�'r NON-RESIDENTIALe
Y'S "'r:?-..?f. v:3 ':.�".-i h.Y-`a'".SaS.,F�S tVALUES`L� `''; AT-100%OF.TTVs-g g- YALU a.�k`aAt.UEJi.."r.' 14r.
Land not exceeding 1 (one)acre immediately l lepce. '-_ g d
surrounding residential improvements. (1) v "�d3' ;� .
Other land (2)
'doer rx ei
Total land(line 1 plus line 2) (3)
Dwelling (4) V`.-`e., ,r -j
'Residential improvements or Annually _
Assessed Mobile/Manufactured Home Garage 5 .� '-- +s-f'I4-544eAM�
Other improvements (6) ' 1;
t-t, -e, a�
Trial improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (6)
I hereby certify the above is true,correct,and Signature of Assessor Date signed
complete.
Verifying action-Signature of Auditor Date sgned
6' ffgz..T`,;: z`tzil .at`2na STANDARI)DEUUCTTON•ALLOWANCE..;=€?rriginc -ri1AWWM7tral, tt„,.,,.,_�,�,.<
20_Pay 20_
Lesser of 112 Homestead
valuationsor$35.000 S
eor�BO \e i / Date Sin —V / - O /