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HomeMy WebLinkAboutHomestead_DelongCLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION smu Porm u7J (Ixs �+m) Praxribed by Me Departmerrt d Loml Govamment Finaxe INSTRUCTiONS: See �e�tiso alda Ibr �p hffiuc0'qy. FORM YEAR HC10 �(1Ne) �i�.�,J�x'Y ify at o 1s of March, 20 I(We) o pied as our principal place o esidence the following described real property for a omes�d rope�C dit i hereby daimed: ❑ 1(W owned ❑ Ne buying under wniract ' Have a benefidal interest in the entlty that is liable for the property taxes on the praperty and ihal owns� �o�r� osii.{wying under a contraU. CUUO 11 buy'u�g on conVaq, Fee Simple owners name Recorders olfice where conVact is recorded .t:.a'.^, r-.�cp..�� `�.,�� -� _?�:�.5-:'.E2�. � �rr.���S�i ca�y To,�,sn�P �-1 l� b� l'1 I• oo I� H any portion of Ne residenLal aWdure w Ihe ot ihe propeM util¢e0 b produce i�ome. exceeding one ry) acre that GIBSON Ta�ing disVict (ciry, fown, township) m i Y AUDITOR Record number Page propeny in quulim: ❑ Real property ❑ Mobile Homo (/.C. 61.1-� that sWCNre is used b produce inmme, desaiba Ne use anC portbn ;��uj^i� ��ASSESSOR`�US�EO�N�L�Y������� li'�TRUEITAX�� �ASSESSED�VALUE ;SHOMESTEAD'i �� H�tES1OENTI�A�L��� �s�yyt�.°,�.,�_:�y.���;r�e,= K.,,J��^�;�g.,� �wVALUEy'�t� ATt700% OF�"7TV� �,�.VALUE�+"�Si � �� ''.`�VALU�_,'�n„ ,y . Land not exceeding 1(one) acre immediately =T'% '^ � ` ��? �* t�'�.�.'��'.,.�°3#� � . surrounding residentlal improvements. - ��� �� `�`�'xE :' � �t'�="$ .�' � u . ti. 3a� .,...-dv...�. Other land � ` -�`�"" �-� `�'' (Z) r ��r � r,�,�� - Total land (line 1 plus line 2) (g� ' ..,='.'r.:��� .-'-� �-� Dwelling (4) �.�i��`��'.`.-�r�%�.�z.z���� �Residential Improvemenb or MnuaOy Msessad MobOe / MarwFacWred Hvne Garage 5 '�..� ��r -�� {"''�` - > ( 1 � ���'���.��i '.T �: y; ,';3�+i• Other improvements ( ) :E`.��`6"'� 6 � �'. ��h�s.. Tdal improvements (line 4lhrough line 6) (�� Rtal value (line 3 plus line n (g� I he�eby ceAi(y Ihe above is We, corred, and Signature of Asseuor Date signed complete. Verilying action - SignaWre of Auditor Date signed 20 _ Pay 20 _ Lesser d 12 Homestead vauaUOn a f35.000 ollwditw $ 3• I•