Mobile Home_Harrison CLAIM FOR HOMESTEAD PROPERTY TAX in I T ;
3 —1:.-14 STANDARD /SUPPLEMENTAL DEDUCTION F R ;� I
7.'' ` ;.' State Form 5473(R12/6-09) ✓ HC1 ✓ 1 it•'%j'-' Prescribed by the Department of Loral Government Finance
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AUG 0 7 2009
INSTRUCTIONS:See reverse side for filing instructions.
/�,- . CERTIFICATION STATEMENT 1 v� 7
I(We) ,% /LI4/ 7l si� /• certify thatlittfI .WTVi 1' ..Ural 3
place of r sidence or am(are)buying the following described real property for which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing):
❑ I(We)own ❑ Am(are)buying under recorded contract
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
•• - - _ •CLAIMANT'S INFORMATION - - _
Name of claimant(legal name)
Social Security number of claimant's spouse(last five digits) Drivers license/Identification I Other number Issuing State
of claimant's spouse(last(we digits)
- _ _ CONTRACT RECORDED -
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
- - - PROPERTY DESCRIPTION - - • .-
^I County Township Taxing district(city,to}vn,township)
�r� /�CZiIs the pro •YWe'
ParcrJ number Legal description • Is the Pro �jy in question:
ii7 g � -) ❑Re I property Annually assessed motile ran. (1C 6-1.f-7)
0 any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is u to produce income,describe the use portion
of the property utilized to produce income.
3-&-yii -os6°s-u°
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- . .. (7 PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES - , •
County Township County Township
`.
I hereby certify the correct e above statements are true,co and complete. t 1L[✓v —
Address(number and street,city,state,and ZIP code y x 1 y Yo
S 3 E Co 50 a z I E+o r 1lJ
(ASSESSED VALUE( iHOMESTEAD NON-RESIDENTIAL
•• 'ASSESSOR USE ONLY. • I TRUE TAX VALUE a VALUE
I. AT 100/o OF TfV VALUE t _ ty xfp-Z ,
Land not exceeding 1(one)acre immediately (1)
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surroundin• residential im•rovements. R ..,2+.r1?^
Other land . .
Total land(line I plus line (3) -- �ti .n_- W c.,Jry ¢r..
FtL u'a. 1 ' ?'� G a�
Dwelling (4) 3r
Residential improvements or Annually u 'm t a' C':1��` gAG ?• +f
Assessed Mobile 1 Manufactured Home Garage
Other improvements 1111Ma
Total Improvements(line 4 through line 6) 121110111171i1111111111
Total value (line 3 plus line 7) Date signed(month,day.year)
Signature of Assessor
C I hereby certify the above is true,,correct,
Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor'Q�J„0\N. . . -
STANDARD DEDUCTION ALLOWANCE • 1.
20 pay 20_ Lesser of 60%at the assessed value of the homestead or 545,000 _ _ f
an del provisaor>he sum of the dedW r °4
NoNrlihstandm9 Y r' _ I —'�•
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