HomeMy WebLinkAboutHomestead_Scheller (4)�rt��° CLAIM FOR HOMESTEAD PROPERTY TAX
'4"�° � CREDIT/STANDARD DEDUCTION
'� � State Fortn 5473 (RS / 10-01)
Presrribed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side (or (iling instructions.
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FORM � YE R �
� H , � �J _
I(We) ' certify t e�J.day��blar�h, 20_
I(We) occ pied as our principal place of residence the (ollowing descnbed real property for which a H e��grp __y!FgTc'Credl�l� here�iy Gaimed:
.
❑ I(VJe) owned ❑ Are buying under wniract
�ave a benefidal interest in the entiry that is Iiable for the property tazes on the properry and Ihat owns Ihe property or is buying under a contrect.
b.�� yy�;s: r . .y' �..�s a � . - t� n•••.CONTRACT�RECORDED-.si„° � -
r-Fs,:z.c . , .2�.�.`... "� �_�.. �...x ..... "' ,1 -> z, z.+:4e r :-. ; ; -:
rl L "
If buying on conUacl, Fee Simplo awner's name
RecoNefs offica where wntract is recorded Record number Page
4��;a'-`..�,�"��?t, ��,:.�.r t� -�='�.,- -. -r:�.'•':.'�PROPERTY.DESCRIP,TION:��.�, :,z.�,� ��:.- �-� . v:: zi.;
Counry Tavnship Tacing dislrict (city, fown, township)
P cel nu1mber .�`/y�► I e -ption I Is the properry in qu ' n:
l� V 1 3� � a p� eal pmperty ❑ M1lobile Homo p.C. 61.1-7�
It any poAion of the resiOenUal sWCWre w the land not eaceeding one (1) aue that immediatey surmunds that swc[ure is used b produce income, desai6e the use and portion
of the properry utilizeE to produce inwme.
'�� �� p SSESSORUSEON Y��* �e� -s� �s�TRUETAX� ASSESSEDVALUE �HOMESTEAD� ��s !iNON�RESIDENTIALy�t�
��'��". �" -_*'..ii.� 3..�*4�:,;4t"t':.�.. `�'�i :ti,. ,._., i�-K VALUE�r � ��'AT100YoOFjTN ,�_ VALUE��� �'' ,.,�,_�VALUES„-���'�o.,,.
1
Land not exceeding 1(one) aue immedia[ely ,��� �� A� �T`-1� ��' i ,:,_
surtounding residentlal improvements. (�) - 'tp{,_'�'� �: �-.-i � r =.
Other land (Z) t"��..'-'�°`, � q,,, °,�3'-.' Y
Tdal land (line 7 plus line 2) (g�
'.is'� r-'.x3�s �?w���i-��Sky : ` c
Dwelling (4) i �i �^,f. � 'x
Residential improvements 3� z�' '�'���r r :,.�� ss"�?:�i
Xx-e�' - .� -�^•z:�.�r �:
Gara9e (5) �•i.� r}��s�E;�� `�r�.,4h+s-':
'-'-c"�`;�.�'«;�� ,..;.
�.s w±-�-=_ t�_:.,-�e-.,::.',� �. �
Other improvemenis (6) -. - ��
y - .� it��,-%
Tcial improvements (line 4 through line 6) (7)
Total value (line 3 plus line n (g)
I hereby certi(y Ihe above is We, correct, and Signamre ofnsseswr Date signetl
complete.
Vuirying action - Signature oflwditor Date sgnea
.�"'-4_� sdE,� _;..'Sk.��::z�P`'r!`°f .�:x't �'��a� i>STANDARD.DEDUCTIONALLOWANCE �.rr.:%'+r'i!a.� .a'�::ut.' .: '.�_-'`._y`�'�'����'.= �,...
20_Pay20_
Lesser of 1Y2 Homestead
Valuation or 56,000 5
Sgnatura otAudita Date signed