Mobile Home_McKee 45.47?- .
' CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT/STANDARD DEDUCTION F g c 'a-
State Forth by the(De art03) ;�
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Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
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03 1; r`. - ,s i€7 `. ✓-1,4a y .-titii0,g t;,,.':;"'=FcERTIFICATON$TAiEMENT? , i 1 j
I(We) 47 a eki_w r c ' that : the 1s(' -y,March,20_
- I(We)occupied as our principal place of residence the following described real property for whi a nsitiey Lrc AtIcSudit, hereby claimed:
❑ I(We)owned ❑ Are buying under contract
$�y Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
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..�- .,. v.�:._�:t3'"'�",rat.'r">r'�:�=?<....��,�.lCONTRACTYRECORDEO :::-z�"�4.�nS���..';:�,�.?�.. z.'�-`�v.,Z`.'=t_�tt:XIV.,-S$-Cf`-:...>.-.w•h2l
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
ir:s s ':;'v' `3+:n':' 7 Ott 5e".. r't;& ... eRROPERT.Y DESCRIP,TIUN(! .F-rsk'S-:tt v,/ 'y9Y- . •m. VII-W icr.. : : q?'.
County ,/ � Township Taring • t(thy,town,I wnship)
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'aril u[n}b/gr 4 1/4%. �j� L cd on • Is the property in Question:
r Yy Mai", -CZ / ' ( J ❑ Real properly Mobile Homo(LC.6-1.1-7)
if any portion of the residential structure or the land not exceeding one(1)we that immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
W4 1: .' -`psg,'sd a-eraPROP,ER.TYOWNEDIBY.CILMMAtitl OTHER:COUNTIES _WW5i;? y-`r tjil.if :,'.. ;3tAr
County Township County Township
I hereby certify the above statements are true,cored and complete. Signature o hnna�n{t, •
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Address(number and street,city,state,ZIP code) X PP f/ t/p {,�)" -
7=ti 4,- a°° -s s Ertwolrpi r`i 3a. -TRUEaTA— .A3S VALUE tHOMESTEAR Y'-y'-r 'y` " ` .r-h;
•RiUSEONLY-y,- sk rc 1 -�+�tNON�pES(DENTIALt<
s .. ,. . ,..-{1rk` . '.s r t. "¢fi��. " 41 >E N%1L11 " - . �, ATV,,OM Tfw^ tcw?'.'4`'^Nt -a"'..G "S'.i,T',�•..VALp ".)-i is
Land not exceeding 1 (one)acre immediately (1) -- ?' ue ri
'surrounding residential improvements. ;� Ir rS «�:t �wS -
FA-i -rS Other land (y) I 1
Trial land(line 1 plus line 2) (3)
Dwelling (4) }.R ".`•.,$a'3iaTfk.W N ',`t
Residential Improvements or Annuely rr. r } �•,,.
Assessed Mobile/Manufactured Home Garage (5) 5y��f--
- : 'rs:.'3:: yti-.'.?s.- s+t ccs; .y-1nt::;!�.
Other improvements (6) '• -(`"`M
r:E 1`' ::-"Th
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,cored,and Signature of Assessor Date signed
complete.
Verifying action-Signature of Auditor Date signed
— 1 I. S- C It 'AM cttrr g `" C( ,,, BTANDARR.OE�UCTIONALLOWANCE -3 ;.:'-?3 r J �:e ' i%�gr.a�v'"f..{t �:®
20 Pay 20 \' II�
\\ Lesser of 1/2 Homestead Wi yj \Q S \/\ \nT,
3D valuation or 535.000 \o\\\�- \ \ \ 1 U
Signature of Auditor - 111 Date signed