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Mobile Home_Wrightlir »c-�' _ r--- �` .1 T:BT a; ' :.- 11 CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR �i"� CREDIT/STANDARD DEDUCTION �(� �y State Fonn 5473(R6/4-03) 111 �\`( H C 10 Prescribed by the Department of Local Government Finance • INSTRUCTIONS:See reverse side for filing instructions. J) t--ni.v ey""4;ri aqi`. , T t sC RTITICAT1ON STATEMENT:; .v>< -ti A^- •". v'0" x. + .y. I(We) I %rtifY/that orl teJal day of March, 20I(We)occupied as our prinpal pia f residence the folio i g described real property for whi a Hatf Property Tax Credit is hereby daimed: i ❑ I(We)owned 0 Are buying under contract 1 1 2 20U6 Have a beneficial interest in the entity that is liable for the property taxes on the property and that oils the property or is buying under a til contract. d.. 6 "-I 1-(7- c:itat->r e AliM `LGx>i~v-'sea;Slf�t,'�4. .4t rd',iCONTRACTRECORDED.a3.,man -+ '- -VMAUuVSt4at 'F�'au�''W.,”" 112 If buying on contract,Fee Simple owners name GIBSO N - Recorder's office where contract is recorded Record number Page z s.2c''s ",/ C!: * t '.yux.` `� ,r .- .,b" 3P,ROP,ERT.YDESCRIPTI0N?cn.+!- `f-s tg=. 'ys. ', ': tli ,,. � .g+ '#€il:.y4�9h a(F sr.:�: - �- .� 1'���.g3Ca County n_ _ Township Taring district(city,toleart idiip)� in A Par ', r//t I to Legal description Is the property in qu/es on: ` �^� iN0 ` Y.br�/ El Real property `1L Nobile H. ty.6-1.1-7) If.• •+-ion of the resVential structure or the land •ceeding one(1)acre that immediately surrounds that structure is used to produ income,describe the use and portion of the property oil!' to produce income. `ram i , a1 - it in' oak / 7 WiSaWetPri' - sp' .--al ".=P,ROP.ERT`/;OWNED'BY CLAIMANT IN',OTHER COUNTIESM;-Xes_;'*-A;a4 r:%:-.ataallia County Township County Township I hereby certify the above statements are true,correct and complete. ie of claimant ,.{.(s) ,/dt Add r VJ 7) of wl C. !Iumber and skeet, state, /O S code)0il0 tu lT W `ni -, :i- (11 l o g— ?r`j^�-s" 'ASSESSOR 11S ONLY +-' -;- y aTRUETAX jai ASSESSED VALUE r O ESTEADf�'WaiiiN,-RESIDENTIAL t Ni`.Xt : ar,Xk,4t-o. =ac t'_r`r-: ,,"+, ,. IVALU.ES5 . t''AT_,7oor OFTTVaP VALUE�€' 4``%',•;, ', VALUE 1. k3 Land not exceeding I (one)acre immediately ' a tf' 'rta surrounding residential improvements. (1) X Other land (2) istg,- Trial land(line 1 plus line 2) (3) 'u' r'.-n_ £:."n'S r_-r . Dwelling (4) ,y�•rT rr,-��. (Residential improvements or Annually 4.'-�." " ' '" Assessed Mobile/Manufactured Home Garage (5) F..,r/„,;,Jv.r.-ri,-1;,. "`+ _ ve-n- y flTOther improvements (6) �' n . a ai s' Trial improvements(line 4 through line 6) (7) Trial value (line 3 pits line 7) (8) I hereby certify the above is true,correct,and Signature of Assessor Date signed complete. Verifying action-Signature of Auditor 1.2k Date signed ._ tin•.=_ NAx,';tT;3sINF,.,-, STANDARD:DEDUCTIOWALLOWANCEZ'Yny+g,Wiy�.��.""r_''F'—.-�'� - Dj�uzTE 20 Pay 20 Lesser of 1/2 Homestead Z Valuation or S35.000 $ to o itor I/ a Date I/6• _ •/^ /