HomeMy WebLinkAboutHomestead_QuinnCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
S�M Form 5173 (RB / 4-03)
Resrnbed hY Ihe Departmml d Local Govemment Finance
INSTRUCTIONS: See iew�raw ald� Aoi IDYg ia6udiont
}� �� YEAR
H �0 li �
Ii ����
OCT 0 7 2005
, . � � «� i-- � �,
� �' �" 3� �' 9fr"4��
� M�e) certi tha �d� i,vJi � �i��s
I(We) occupied as our principal place of reside Ne foilowing described real property or which Homeslead Property T� Credit is hereby daimed
�I(We) owned ❑ Ne buying under contract �
' Have a benefidal interest in the enlity that is liable for the property taxes on the property and �hat owns the property or is buying under a conUact.
11 buy'ug om m�irad, Fce Simple owner's nama
Remrdefs olfice where mnVaU is recarEed
County
To.mship
town. IownshiP)
Record number � Page
Parcel number Legal description Is the O�Pen`/ � question:
� 1 �' �� �� (o - a C� �i wovenv ❑ r.+owia Homo o.c. 6 �. �-�l
If any porlion of the resitlenllal sW cture w Ne land not exceeding one (1) aae Ihat immediatey wrtounds Ihat sWCture is used b pmduce inmme, desviba Ne use and portbn
o11he property utif¢eE tu produce inmma.
sr�.9;' ' a,y'�`�?'�L�• !^-�i s� � _ n.m.nN.. � . . , ,�,h . „> .�. . � y...
��-��'� �ASSESSOR�USE ONLY=� K�� TRUETAX�� ASSESSED��VALUE. �HOlAESTEAD�` NONwRE5I0ENTIAL� a
�,c�� . �;.r�.� s�n.,,py�r��rY":?���s..,�! �i�VAI:UE`�,+.� �ATat00Ye'OFjTfV� -�,VALUE�� �����?�G.VALUE�..�.�. :`i?€' �
Land not exceeding 7(one) aae immediatety '"'"`� i�'�.� �-.�*�'z- ;wY'n
surrounding residential improvemenLs. ��� �� �'-"��'a"` � ��'�`'� �;.-t �'',
J ��{'i � :. SV � '(��'T
�•r..i � -�^.�.�.i 'ch�t'-. .
Otherland (2) q����"�-;"" Y
-: E:s-V; �,t:�=LL:�"'
Total land (line 1 plus line 2) (3�
bn? F-v�t€rh' a�.->.+�_ icri 1
Dwelling (4) } ` sx ���i zd�` �a
�Raside�tial improvementa or MnuaOy "�•" �''f����� �'. "Y�"•�� �'�"b
Asaessed MobOe! ManufacWred Home Garage 5 ����.� s,r `"`��''�� "`
( ) ��-s. �'. ���-�y—' �„"�..�
+.r�7:�3�`_ �ar:�fi
Other improvements (6) .��'�`"��,i��
�J a...
m�; : iar;,:
Talal improvements (line 4 Ihrough line 6) (�)
Tdal value (line 3 plia line n (g�
I hereby certi(y Ihe above is We, corred, an Signatura otwssesmr oa�e signed
compfete.
Veritying action - Signature of Autlitor Date signed
20 _ Pay 20 _
Lesser of 1/2 Homestead
vauanon a 535.000
S
ofPuditw ' Datesgned
`-M n, al � K� . i o-1-