HomeMy WebLinkAboutHomestead_Birch„ rt•� . CLAIM FOR HOMESTEAD PROPERTY TAX
- �” � CREDIT/STANDARD DEDUCTION
` J SUte Fwm 5473 (RS / 10-01)
�°� Prescribed by lhe Department of Local Govemment Finance
INSTRUCTIONS: See reverse side /or filing insliuctions.
FORM hA YEAR
HC10 � v ey,
J
�(we) _�u,� {�� � 7s�vlw��J�.. �� �/�r ���if�jF�t �� 1 sl day of March. 20_
I(We) occupied as our principal place of residence the following descnbed real property for which a Homestead Propeqy T�c Credit is hereby daimed:
❑ I(We) owned ❑ We buying under contract �
�ave a beneficial interest in the entity that is liable for ihe property taxes on the property a� CIB� ppprtv� js `yjng under a conVact.
t t'
if buying on contract. Fee Simplo ownefs name
con�reclisrecorded
Record number I Pa9e
Counry Toxnship Tacing district (ciry, fown, rownship)
P�el n —r � I� L de ription �-� _ D Q ' Is the property in tion:
1 /'1 �"1.0
\L/ � {f��ea� D�oDerty ❑ Mobila Homa (I.G 67.74)
I( any portion ot thB resiAential shucWre w the land not exceeding one (1) aae tha� immetliatety surtounds �hat sW cture is usetl b produce income. desuibe the use and portion
o( the property uWizcM to produce inwme.
Tavnship
I hereby certify the above sfatements are true, wvect and complete.
�:
Coun�y
To.vnShip
�� ��A ES�SOR'�S�����.. i='� ��,VALUE i��r,y' ^AT 1 OYe OF TfV y�4y§.��..VALUE'� � r��� VAI.UEN,,,;_-_`��,�,p`.,`.
'.;�
Land not exceeding 1(one) acre immedialely ��) :��±�����`� �� r j'8;..�
sunounding residential improvemenLS. �r,s, .s�yyte�i�,,,�___ ��. ; _
2 � ���+���=�
Otherland ( ) .�, Y+4.��y �
Tofal land (line 7 plus line 2) (3)
�`svr ���y� 4 x3�",.an, ��..�
Dwelling (4) ��1 � X'�� £ TK �;�5�+
Residential improvements �`�� a�'�''"�5��� �'
a : ;�--a=yt�n'r�✓s �..
Garage (5) ��(���'T` ��s �t . = �����:
'y 21. S'..}..�`h'"��..�._Jta'�t{'Z .Y '
�_i.ei,/;n'�� y'C..�"�. 1 ��i
Other improvements (6) � � s.�=� g�_ �
r=�,' ?T;i3:F`M,:�'
Tctal improvements (line 4 fhrough line 6) (7)
Tdal value (line 3 phs line � �g� � �
I hereby terUfy the above is W e, torreG, and Signature of Asseswr Date signed
complele. � .
Verifying actbn - Signature of Fwdimr Date sgned