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CLAIM FOR HOMESTEAD PROPERTY TAX FORM ISAR
• CREDIT/STANDARD DEDUCTION HC10
State Form 6473(R6/4-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. • ;--
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�-h_.' -`g *.. lfre-. -cW4-1 h CERTWICATION.STATEMENT=sjt{Sa:t.. n;:t r-r-h;;3i 2 a\Fg_i r wsw-' i :
I(We) -�}T.. "try 1(2 (hh the 1st day of March,20
I(We)occupied as our principal place esidence therfollowin escribed real property for which at- mastoid Property Tax Credit is hereby claimed:
D I(We)owned ❑ Are buying under contract I / (/ /1
Have a beneficial interest in the entity that is liable for the property taxes on the propertyiand that.owns the p /I roperty orW buying under a contract.
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:ram -kAa' - lr �-* c_ --`t - s a a z�."� i_E3"_P+3� i��.c;'Si+;'i-a<L:_
rssti..-.c �t�:r3�'-?.i>= �a=_.�s.+��at�-P .� a"-�, 'J`4"'"a'r<CONTRACT-'RECORDED !"s'f,' t��fi-i_ ` . 4`t-. ..k,. "` .. �.'-
If buying on contract Fee Simple owners name
Recorder's office where contract is recorded Record number Page
.ems ._ �_ ;D -'- - - M
:ri =."'.r`''.t;` '=i�`� r-=��-�- ���m'?���'L.;,r4P,ROP.ERT.Y<DESCRIPTION"�}I'3'a:,iss(�_?:lei ?��-.,,4'4, ,-z`. r Ate :dta4Ti;:5
County Township Taxing district(city,town,township)
P r kleag� ,�,\ Leg dycfrg pXg a�/� Is the property in question:
b W l Li'W a l �+ �., ,O-� ❑ Real property bile Homo(LC.6-1.1-7)
If any portion of the residential structure or the Ian not ex g one(1)acre I immediately surrounds that structure is used to produce income,describe the use and donjon
of the property utilized to produce income.
r- " S* o- i'' gW FROPERTY,OWNEDi BY CLAIMANTtIN''OTHER'COUNTIESf" 5rie4i`,r+Y!{=. .�s'[_-.'�'�a�;% l.4.3 �'a`..
County Township County Township
I hereby certify the above statements are true,correct and complete. igna re claim nt Ad I,f}►� ^ ,
Address( Rr pndp'Rpef,city,stet? a /�, "`�(R 1,`d,rill
fs,
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1xG" :LyE'rt - .5€a'Jcl,« .iteika r 1T 4- -
ASSESSOR USE ON -s;' {SV �E f qT 100/.OF TTVMAYA-STEADALUE ��NON-RESIDENTIAL
is _ .Ah`.£• *' .>r_ * €v'.`,'';;a ix.-. .. .r.. ..,..—int.w.. JSn -i'Y4'r,.VALUE a4.
Land not exceeding 1 (one)acre immediately (1) I r i 5. it ci° j ,
surrounding residential improvements. '�' ,:8 . 'xcic:= 1 'q
Other land (2) { 0 7''
ratit.
Total land(line 1 plus line 2) (3)
Dwelling (4) *sY Aa rt�+ `t#-4'
SUResidential Improvements or Annually `'`"-ef:! �t:o.' -''•'? u
Assessed Mobile/Manufactured Home r , trn r,_
Garage 6 r�,agg, ,1 "'<v��,c�,i`'".h_
Other improvements (6) tr ..;?`bi�_t}+�--,,, `'
Total improvements(line 4 through line 6) (7)
Total value (line 3 ohs line 7) (8)
I hereby certify the above is true,correct,and Signature of Assessor Date signed
complete.
Verifying action-Signature of Auditor Date signed
I- -W ,'r , -ZInC6 r'e rirjsr^� - CISTANDARD.DEDUCTION^11.10WANCE?s ;'.r., g. 4 'y`,"avzr M- ^'=;. 'M4cE4. i W,s :,n'«.,F'
U 1 \ 20 Pay 20 kLesser of 12 Homestead \y"�� (1�1,1 ``vN I(\��Da0\ Vauatton or S35.000 \ \Cy. \iJ \` SQ \AI,
Signature of Auditor - \ Dale sign