HomeMy WebLinkAboutHomestead_Smith (17)CLAIM FOR HOMESTEAD PROPERTY TAX
- = CREDIT/STANDARD DEDUCTION
t � State form 5673 (RS / 10-07)
�w Presaibe0 the DB
by parimefrt of Laal Govamment Finance
INSTRUCTIONS: See reverse side Ior filing ins(rvcfions.
/
FORM Y�R
HC10
I(We) V- / �iity Nat on the tsl day of March, 20_
..I (1p(g) occupied as our prindpal piace of residence the followi descAbed real property for which a Homestead Property T�c Credit is hereby daimed:
�1
,�I (VJe) owned ❑ !ve buying under cont2ct
: Have a benefidal interest in the entity that is liable tor the property taxes on the property and that owns the property or is buying under a contraU.
I( 6uy'vig on conVaq, Fee Simple ownefs name
Retordafs ofite where tonttatt is recwEed
Recard number � Page
Cowrty Tamship 7ating tlistrict (ciry, tawn, fawnship) .
- -b
Parcel number L desaiptio� ,`_ ,� Is the property in question:
\ \ (\l1 . � ��m, ❑ �blle Homa (l.C. 61./-n .
l�1'l�l.xD
H eny portion ol Ne resiEenUal sWCWre w Ue lan not axceeEing one (1) aae �hat imrtredialey wnounds that swcture is used b produce incane, describe the use and portbn
W the properiy utlizeO tn produm irkome.
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I hereby ceAity the above statements are We, cortect and complete.
Address (num6er end sGaef, city, atate, ZIP codey�
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�^",�=�N'���.�����z�-�`� STANDARU:OEDUCTION'ALIOWANCE.°.�.� �.�"y� �i^�`iz'.,'�S`t`_-���`'. �,���C. �. � _ �=
20 _ Pay 20 _
Lesser of 1f2 Homestead
Valuation or $6,000 $
Signature of Auditw ' Date signed