HomeMy WebLinkAboutHomestead_Stone (6)r�CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
/ Slale Fwm SG73 (R6 / 1-03) .
PreSCribeO by Ne DeOartmml of Local Govemment Finance
INSTRUCTIONS: See revcrsc side /orliling inslnicfions.
FORM YEAR
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I(We) ��rtiry thal:on�the 1st'day of MerGi!20
�,✓y.��, �,�
I(N!e) occupied as our principal pl oi residence Ihe following described real property tor which a Home"stead,groperty,Ta�;Crediyis hereby daimed:
❑ I (VJe) owned ❑ !ve 'ng under wntracl �
' Have a benefidal interest in ihe enfity that is liable (or ihe property taxes on the property and that owns the property or is buying under a conVaU. -
I( buying om m�Vaq. fee Simple owners name
Remrders olfice whera conVact is remrAed
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CountY _ , Tavnship
Pa/�)e/IP umbe�r( n7� j �(J� ^( Is/ih1e/ paro
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Nany ponion ol the residential struqure or tha land not exceeding one (1) ave that immediatety wrrounds that
ol lhe property utiiaetl to produce income.
Toxnship
I hereby cerGfy fhe above sUtemenls a2 We, conect and complete.
stre,e�f, �c+ity�, sta(e, ZIP code)
GO�w .-�E �^�t%
�
County
of claimant
Record number � Page
al Droperty ❑ Mobile Hwno (I.C. G1.1-7) .
is used b protluce income. describe Ne use and poNOn
r�c ;,�K �n>°.?�'"��`u-s.....-°s�f^"'e,-'.'�- �s ei . . . ,�_�-.,.. ,; '_�.--�.- s'"` - p f
��ASSESSOR�USE ONLY-.���+"Ecr'`��' k4'iTRUETAX r ASSESSED VALUE�. �+HxOMESTEAD NONiRESIDENTIAL �g ��
t�'E:�-`''�.`"i!��'.�d.�`�7;?,5+�,+k+czafti#45:�:....'s�-�-4�:s�y�1".a ��VALUEi„�ut� �_AT100%AF�TfV.H#��'L,VALUEr�.�e.'�.��.fi4.°�.��...VAI.UE;,s,-"JGi�
Land not exceeding 1(one) aae immediately ^" `� +"��;
surtounding residentlal Improvements. (� � �� �{�-'����i��� •
u ,a 7� lZ�'. n.-= .S'.
Other land . �Z) �.�`��G ' "� „�' �
.._��.� �
Tdal land (line 1 pfus line 2) (3�
c- �a a-s=- ��i?�
� . .. i b,�"i�lry 9??3
Dwelling (4) ��?��c ti.�. ��'�
Residentiel improvemenfs or MnuaOy
Pssessed Modla / ManuFadured Home Garage (5� ���'����s������
�
4 y
Other improvemenls (6) '��-3'�'�'�'
� Fh���-�
Tdal improvements (line 4 through line 6) (��
Tdal value Qine 3 plus line n (g� �
I hereby certify the above is We, coned, and Signature of Assessor Date signed
complete.
Vrrilying action - SignaNre otluiCitor Date sgnetl
__r�"�'-�.R`f3':?i.�„-�-'.�f'�.,��s`T�.`��",,.�'�.�-3�3'�k"� :STANDARD:DEDUCTION'ALCOWANCE:.Y..'�i'i�-1:f?yf"��yns�'`.':�Y.��`�'��:�,.'�r`�.s�;a+T<�..-.�-,?
20 _ Pay 20 _
Lesserof t/2 Homestead 5
vauanon w 53.5.000
5'gnature o(lwditw ' Date sgned