Homestead_Schaefer' CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� State Form $473 (R6 / 4-03)
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Presaibed by lhe Deparimeni of Local Govnmment Finance
INSTRUCTIONS: See reverse side for filing instn�ctions.
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FORM YEAR
HC10
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��e� � certify ihat on the 1st day of.March 20_
I(VJe) occupied es o prindpal place of r'dence the following described al property tor which e Homestead Property Tmc Credit is hereby daimed:
�I (VJe) owned ❑ Fve buying un er conVact
/ Have a benefidal interest in Ne enliry that is liable for Ne property texes on the property and Nat owns tha property or is buying under a conVact.
�f �9 �+ �a Fx su„We wmers wne
RecoMers olfice where convaq Is recorded
Tpvnship
distrid (ci(�: fown,
Rewrd number � Pega
Paical numbar a descri lion
''\ P /�,� �1 Is Me property in queslion:
n�vr� i—�(.J � � ��6U IX� ❑ Real proDerty ❑ Mobile Home QC G7 1-n
II any poNOn of Na 25�denUal sW cNre w Me lar�d rrol azcee0ing one (7 ) acre Ihat immediatey surrounds Nat sWCtura is usaE to produce income, describe Na use and portion
of Ne properry utllized to prvtluce income.
O
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.-�_`.�'3v.s� ...�+aF�.,�,'t�r-;$see.x'�'K»">..� . PROFERT/�OWNED'.BYECUUMANT.IN'OTNER'�COUNTIESs .r=.=.�� �.. �;�'.x,s.:. . ..E�; `'_: .;-?:'-
County Twvnship Caunry To.vnshlp
I hereby certity the above statements are We, correct end complete. Signatura of ciaimant
7mss (num6er arM sLeet, ciry, atate, 21P code)
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"� ���'�'.��" aAS3ESSOR USE ONLY,u� � 2 7,�'', i,. �� 4�TRUE TAX ASSESSED�VACUE HOMESTEAD � � NON-RESIDENTIAL •�
t »'� :'t.t±"d?t�.f's':r.�.-sY!`�'�a.:n _ �:.� �eL VALUE?..�. . AT>100%OF`TTV . ..VALUE �a ."t'-7--x �?�^',;�VALUE?- }� _�_ -
Land not exceeding 1(one) acre immediately � y'; � f4�� , .c`� >,_: "
surrounding residantial improvements. ( � .r,. fi,�,;�f. , >`' �
Other land � �2� r ,�x' ,�F�,-^,'` y .
.,
Tttal lartd (I/ne 1 plus Ifne 2) �3�
Dwelling (4) ��`� a�`cs?-'�� e �y�_3 ,�if
Residential improvements or Mnually � e.--< ?'is-, �, �-� ��
Assessed Mobile / ManuFacNred Home � ,n �:-, � * � �.�---a-s:
Garege �g� ' r, � ._ .,,. _
�,.L,-��,:2"��.'-�%�.'�`' �.7i'�.`�
q ,'=>�b
.O�Aer improvements (6) s . ��zn t
-, .. fr, .:�.-.
T�al Improvements (line 4 through lirre 6) . (�� �
TUSI value (line 3 plrs line n �g�
I heraby certify Ne above is We, correct, end � Sip^antte otASSessor - Dau Wpnad
complete. .
Veifying action - SlgnaNre of Auditor Daro siBned
'».��,�i���i+.Y'`"�.s:'�s�^�i:�`��'i�K".`.��r.y�u,ySTANDARD,DEOUCTIONALL'OWANCE `, u°-.%` t .,.�:.�:-��..'t �'['"' •.. A�� -`;.,. � .�;
y.
20 _ Pay 20 _ �
lesser of 12 Homestead
V�uatian w 535,000 5
SipnaWre of tuiditor Data 6igned
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