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HomeMy WebLinkAboutHomestead_BerlinCLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION stsce Fam sa73 (RS � aa3) Presuibed by Ne Departrnem of Local Govemment Finance �NSrRUCnoNS: sea ��,� � ra rr�y r,�u,�wo,�. � � ' � it< • ' � z t ;� ; ;� MAY 3 2006 ��yyg) `' • GIB 9N C u.l a�n 7R � certify lhaCon�e �sf�ay o�f I�Aarch, �0_ I(VJe) occupied as our principal place re ence the following described reat pr rty for which a Homestead Property Tac Credit is hereby daimed: �r (We) owned ❑ Are buying under contract ,� Have a benefidal interest in the entiry that is liable for the pmperty taxes on Ihe property and that owns the property or is buying under a wntract. If buying on cont2d, Fee Simple owners name Retorders ofica where conVad is recarded Rewrd numDer � Page Counry Tavnship Ta�ing distnct (ciry, mwn, fownship) Parcel number Legal description Is the properry in Queslion: ^� al property ❑ Mabila Homo (I.C. 61.7-n If any portion ol lhe residential sWGUre w the tantl nd exceeding ona (1) aae that immedialey surrounds that sW ure is used b produce income, describe Ne use and portbn of the property uGlized to produce income. �1/ _ i9_i9.���.3 m/,�s� �.�� Counly Taxnship I hereby certify the above statements are W e, coned and wmplele. AdEress (�mbererM e�e(, ciry, stare, ZlPcade� , „ � County . . ,. „ Twvnship 20 _ Pay 20 _ Lesser of 1l2 Homestead vaWanon or E35.000 SignaWre of Auddor S Date sig .1�-