Mobile Home_Wilkinsr YEAR 441tr.th a.,r
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' 1 •-4z CLAIM FOR HOMESTEAD PROPERTY TAX
' •-•,:: Thi CREDITISTANDARD DEDUCTION Nnii HT011 . U S
State Form 5473(R5/10-01) LE, _-4/ Fit
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. MAR 0 A 2002
.-ac.:; .;L:-.- ,.,;..-,.Rif„t, ,-;.:. T:::. ,- t,-..-if,i.j • . CERFICATION STATEMENT r
3
I(We) ‘,...1-71-F pfriz,v, , , VS, certi atpagattientjaoy iirMare1312OR
-1,(We)occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
X---..".. I(We)owned 0 he buying under contract
"aye 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.
Pgliale&S-d1/47..arj;71:.;-%-e:7-31-_,1iP3,7i't5C4eera-4it..'eiVt.;:47:3/414;4,--',";CONTRACT RECORDEDi1,32&?-it:4 1/4-cc:1-:,tteiliairtt:- ..rri,-,,,,t,',41;;a1;-1'14S,,;.-,,e-f.,:::: -
If buying on contract,Fee Simple owners name
Recorder's office where contract is recorded Record number Page
Wilt;"7: 191,retki;"Illi: .'V,,fit:±.T.:}ciin-kai;, 12.?!,---Pira;.:pROPERN-6ESCRIpticiprit-T:1-!::;:et44}pcst.:r?tre- ',:-PC-1:rf'ttz:;;;;;:t,24:Vs:1”:"..
Cot(19 Township TaxiAdliict(city, to ship) \
0 i a t 9"Li _
Parcel number Le d_ ript - Is the property in question:
----S- - OCO 779—CC 0 Real property Mobile Homo(LC 6-1.1-7)
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 1
of the property utilized to produce income.
/ q 98 eeLle-a,tnTh
OCA Wei.IN oTHER•cduiartscr::-;;?,;4);"---:;;Ci-rt:P.i.-5:r-LY:f:‘Ti-4 t4: ' ,
County Township County Township
Signet claima
I hereby certify the above statements are true,correct and complete.
\\/ ( -t ) _ 4 _ .___
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ress(number and street,city,state,ZIP code)
411P jj sr 3, 9/14/-Aie )--7AenA l'IL 71 at -,t-ZU 0 W 9 6 3,X.1,3*. yriP):1,4.-1;r9'-c3,,g;*:::15-zt-7-41+:;1',13.:=1;:a.” •Aiiiiiii:fAii,icr..., AisEsucKiALuE irdltivitliiiir- ,N%iirA:FiisiiiiiirikEm2 ,-.:.
:, :,-,74.:::‘ :.7,:--:t
VALUE i:'1:IQ: 'CST 199°A;OF:TTY1 ..:'j."VALUEr„-&-,t"..' Fi'Llit::"- AgY)Erk‘;;.?".1k14‘"T'!
Land not exceeding 1 (one)acre immediately 7'72`317.-i,ha:ti.i?c .',,iiii:;-',I:71:k
surrounding residential improvements. (1) :1,-,f 731,1:1".‘„:71-.. W;;;;_,,tt-
.• ,..: .."‘1..--1-‘' . .Tke-.-r-..-1c.rrrLe i,•
Other land (2)
Total land(line 1 plus line 2) (3)
Dwelling (4) t!1-412,-,15rt
het.12<4-grilirt'ilke,S._4'Sisths.
Residential improvements -
TirttWita:EitirSi.ii:it:?:;-.
Garage (5) r-.1-1,-417_-.11,n .'.4•• r, c:-.1.
, 14•4:-..;-'17.; Cf:*--e-t ,,r-.4'•..:
Other improvements (6)
' -:
Tctal improvements(line 4 through line 6)
Tcial value (line 3 plus line 7)
I hereby certify the above is true,correct,and Signature of Assessor Dale signed
complete.
Verifying action-Signature of Auditor
A Date signed
0 t-ixfiatti:,:tlig.c.SccrettrAl*AK,Viii;P.. 1 1:;.1:I STANDARD DEDUCTION ALLOWANCE" ?...iii7,:CAolil ;::ifictS.Vit*) -.-a:
20 Pay 20
Lesser of 1/2 Homestead \ (b../ fi\\ $
f- S..)) Valuation or$6,000 \
Signature of Auditor Date signed
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