Mobile Home_Russell (2) YEAR CLAIM FOR HOMESTEAD PROPERTY TAX
'i STANDARD/ SUPPLEMENTAL DEDUCTION FORM ---
INSTRJCTIONS See reverse s,de for filing instructor's `s (� .
CERTIFICATION STATEMENT
- Cs .,�in`ral 6 a_ ._ — I. _—cart fy tne'I fhei occup•ed as my,our.pnncrpa'place of
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_. ., .- a a= t.:y:g- o e' 3..ny des':Se:re- e•-
' o,. ,,rcer crlfa:t fa'.v'or a r=c Stead Ptcper-y Tax Standard Ded,.a,c^s herecy ca'^'ed o e
. .�._ = y^ed date of s,gnature! I'We
❑k are .y^o L.--e ___ ___-..-:rac1
0-.- a_ _:'o:ccupy as a:enaot-stocvh.c'der o`a s-cpera:.e'-c-s-:g corccra'c^
❑.,,._,re-:7::,: -_s?rntre trust crtre-.g...,,,___._. . - .._ '-- :: as-a =___sr-a -_,__ __._s.
i E3 Am,are,the sha-e-o'Ser partner,or membe'of the e_. - _:-_
CLAIMANT'S INFORMATION
Reco'der s ON.ce N.*e•e Certract s Recorded :Peco•d\u^-be, age
1
PROPERTY DESCRIPTION
Tcwns"•e Tax:rg Oat-,ct Le to :rsh,pj
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`ega:Descdpr 0^ s r're ercpery.r p;est or
- El=ea.Propery n..,aly:.ssessed ticeie!-ore'C e-,+'
.- . - re res•dert,a sir„st...re or tre!3^d rct e•-ee--: - .a that st-uct.,re s vSed to croduce,,come describe the use and port or
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PROPERTY OWNED ELSEWHERE BY CLAIMANT �(tw"- _c-k-a
State County and Townsh,r -- 3 d'�l Y A `V V3-i+CP
I hereby certify the above statements are tree correct and cornp,e'r_ \/ w i_. zef y /t ''"� , �-
- "'be"and stree• s•a-e 3-.d Z.o_- _ ---- _ - ..a .sd •a - ,.e-as s.,.,.,. .. .'st`a•e amino ZOO.,"=iriJ.••- 0 �,,,�J�J
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ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately I(1) I
Surrounding Residential Improvement I
Other Land 12
, Total Land(line 1 plus line 2) 3 Fit
FLE: 12)___
RedentialImprovementsor : Dwling • 4
Annually Assessed Mobile I --- — --
Manufactured Home ' Garage S
Other Improvements .o 69 4
Total Improvements(Line 4 through Line 6) 2�?4
Total Value(Line 3 plus Line 7) `t G/e$OA. Q ry1 . •
S s-a•_e_ :_secs_- COUNT^0 - "{date ^•or•n yea•'
I hereby certify the above is true,correct,and complete. Y AVO'TO
ft
��er.Pprg Action-S g^azure o'and tc- -. .._ Oa'e S•gred la- mart yes'
STANDARD DEDUCTION ALLOWANCE
Pa.:. -. - - - .., _ ... _. _
2C
Not•ndnatandrng any other prows,rn 'he s,,^r of can deoact,ors pro,'cec a C 5-1 t-'2-s_Tor e ma' S
s not assessed as real property or to a manufactured'ome that s not assessed as tea p cey^3/not ,
exceed one-hart t b2)of the assessed value of the mco•'e rcme or manalach,red pane
Srgrat°r ,d,to• a � t� -\ I Oate Sig-' - '^ '-ct � �a - --
DISTRIBUTION 2,g ra-- __. , -- - - --"ced_ec+- axcaye'
image 1 or 2 Vr\y�.