HomeMy WebLinkAboutHomestead_Hormuth" CLAIM FOR HOMESTEAD PROPERTY TAX � YEAR
� CREDIT/STANDARD DEDUCTION �Ro
` Slate Fartn 5473 (R8l 7-07)
•` Aescribed by Iha Department of L«al Govemment Finance
INSTRUCTIONS: See reverse side /or fiiing insWctions.
�(We) `1 � !�1 � U�-L� � certiry that on ifiE �sl Xay�oiM4�7ch, 20_
I(1Ne) oowpied as our prindpal place of residence the fWbwing described reaf property fw which a Homestead Properp''� �Tayc� Credit is hereby daimed:
�(We) owned ❑ Are buying under contraG !�'� �.���
ave a benefidal interest in the entity ihat is liable for the property faxes on the propeAy and that ams ihe pi'8��ii irsfill�hi'§bRd@flA�caJctaG.
If buyuig on conUaq, Fee Simpe ownefs name
Recordefe office where conVad is
Counry
Parcel number
Tamship
Is I�e
IY--� ylt ylG, /4'-3-io I
If arry portian oiUe residential sWClure w ihe land nd �ceeding orre (t) acre Ihat immediately wnnunds Ihat
ot Ne pioperty uliGZed to produce inmme.
c�� - I 9-�9- /oa -oov. a/� -oa�
IRecord number I Page
townshiP) ,
question:
�� � ❑ M��
is used In produc8 inmme, descnba Ure uu and pOM1ion
.- .
. . .. . .
„.. �
Lami not exceeding 1(are) ave immediatety �. � . .
surroundi�residentialimprovements. (�) ' �
Other land (2) . .
Tdal IarM (line 1 plus line � �3)
7 .' -, . :
Resdential imprwements w Mnually ����� (4) - ::, � �-:r •.
Assessed Mobile I ManuFacWred Home �� '�
Garage �5) :i:.�•. �' -': � - -
Other improvements (6) '� � "
,� �
Tctal improvements (!me 4 tivough Gne 6) �7�
Tolal value (line 3 pl�s G/re n (g�
I hefeby ceffify Ifte aboVe IS hue, coffeG, and Signalure ofPSUSSOr Dale signed (monN, day. year)
complete.
Veifyinp adion - Sipnature ot �tcr Date signed (monlh, day. yee�