HomeMy WebLinkAboutHomestead_Brown (11)--. .— .�. �,—�
CLAIM FOR HOMESTEAD PROPERTY TAX �+�FORM — ; �� YEAR
' CREDIT/STANDARD DEDUCTION HC"1o� �
S�ate Form 5473 (RB / 4-p9) `
Prescribed by Ihe Departmenl of Local Govemment Finance A � i� T
INSTRUCTIONS: See revcrse side (or (iling insimcfions
I(We) �� certi{y Ihat on the 1st day of March, 20_
I(We) occ 'ed as our principal place of residence the following described real properry for which a Homestead Property T�c Credit is hereby daimed:
❑ I(VJ owned ❑ Are buying under contract
' Have a benefidal interest in the entity that is liable for ihe property taxes on the property and Uiat owns the property or is buying under a contraU.
If buying on conirad, Fee Simqe owner's name
Remrders otfice where contraa is
County / Tdmship
i�/,6(1'� C�.
Parcel nu - r ��� L desc � tion
It any portion ol Ne resiAential sW clure a the land na exceeding one
ot the properry ufilizeA W produce inwme.
Record number � Page
(ciry, town,
'„/ �_ q I� I Is Ue property in uestion: �
, i Y,y/ d eal Droperty ❑ Mobile Mwno (I.C. 67.7-n .
ave ttiat immediatey wnounds that st cWre is used b produce income, desaibe the use and pwtion
'�3�'�y�3b'�:i �ft5^3rt� �..-d.Y �25 i"^�'- xr.�.w. 4:v- � Y }ts- �¢e.`�
' f� � '-�''-'ASSESSOR USE ONLY�'c` r}"3�i�� �RUE TA�X �� �ASSESSED VALUE �aHO1dESTEAD� � NON`-RESIOENTIAI �� "�
+� _::'}���s.T� 4�fi�Si;��`��� �.s� �.�.t.VALUEyYz`l.� ::.ATyF100 /eA.F.�.TTV,� +<."4a�c.tiVALUE� e:��%?���VALUE��.a_
Land nol exceeding 1(one) acre immediately � w���-�R"..�-� �.'+��gtyjF
surtounding residential improvements. (�� � � � -+ws}$ �;
��� �:���:.
Other land (Z) ������� � � �
-�ras7.��.�:
Total land (line 1 plus line 2) (3�
as cr.�;�i':'7�t�. "i£' .�}i
Dwelling (4) ���_��, ��� �
Residential improvemenLS or MnuaVy � � �� �
Assessed Moblle / ManufacNred Home Gara e �'i?s, � s,,�r.�`st s-,;.
9 (5) ��. - ,����_ ��- '�'S,��
g.+Tsc-� i
Other improvements (g� ��•,; ��3����
'�..a``,_ a -�'f
Tdal improvements (line 4 through line 6) (�)
T[fal value (line 3 plus line n (g�
I hereby certify the above is We. torred, and Signature ofASSessor Date sgned
complete.
Veiilyirg action - Signature af Autlimr Date signeA
�'s.m.s.���'�- ,��.3..ak:`.u'ti�+�^��+� n�`�s`.''`-STANDARU;DEDUCTION�ALLOWAIJCE��� �"�"`°. �t. -- � �.�--� Kv-t .�-N �. ;,_�-,
'/� yr � .e
: . �. . r . ... .-r.w.`&^lai k:4r��zSaa�Z-5:-�:��i°k,s��a�R-°�'%�.?iv.^.e
20 _ Pay 20 _
Lesserof 1/2 Homestead S
vawenon w E35.000
Sgnatureo(lwddor � Datesigne0