HomeMy WebLinkAboutMobile Home_Bourne il!''~ HM PROPERTY TAX FORM Y AS_
ti STANDARD CLAIM FOR ! SOUPPLEMENTAL ESTEADPERDEDUCTIO N
HC10
N. J' Stale Form 5473(R19 1-23)
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VPrescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
NOTE: Telephone, Social Security, driver's license, state identification and federal identification numbers are confidential under 1C 6-1.1-12-37. 1()I 1
j'•� CERTIFICATION STATEMENT
I (We) ell, ('P f Du a1 certify that I (we)occupied as my(our)pnncipal place of
residence or am(are)buying the fol( �j rl5operty under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date this application is signed, �jj ((JJ.(. (date of signature). I (We):
14:wn ❑Am (are)buying under recorded contract.
❑Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust.
❑Am(are)the shareholder, partner, or member of the entity that owns the property.
CONTRACT RECORDED
If Buying on Contract, Fee Simple Owners Name
Recorders Office Where Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
Cour_ily. Township Taxrn District(city. t n. town hip)S tiki
rivoir5
o,za.,
Parcel Number Legal cription Is the property in question
❑Real Property nnually Assessed Moole Home(IC 6-1.1.7)
If any portion of the sidential structure of the land not exceeding one(1)acre that immediately surrounds that structure is used to produce income.descnbe the use and portion
of the property util ed to produce income.
_ , ,
.-' i r` - ►--- . , `T) Th re
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township .di't:ant Va ting a Homestead?
I0 Yes .7SI No
Signa re of Claimant
I hereby certify the above statements are true. correct, and complete.
Ad s of Contac umber� free, city staterid ZIP code)
�/, AdCfPSS^ tarH. Ps'eaa 't 3 � f'r.7rrd StrnC'. city. s'.3te and ZIP code
*
✓ i 11 'V :I\fe !
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL VALUE
Land Not Exceeding One (1)Acre Immediately
Surrounding Residential Improvement (1)
Other Land (2)
Total Land(line 1 plus line 2) (3) TILED
f____
Residential Improvements or Dwelling (4)
Annually Assessed Mobile I
Manufactured Home Garage (5) MAR
Other Improvements (6)
Total Improvements (Line 4 through Line 6) (7)
Total Value (Line 3 plus Line 7) (8) Y 2 ,,.1 .,./.1 a v i ri 4 e..,;,i 4)
Signature of Assessor GIBS UNY`1 nA INTOR
I hereby certify the above is true, correct, and complete.
Verifying Action-Signature of Auditor Date Signed (date, month,year)
STANDARD DEDUCTION ALLOWANCE
20 Pay 20 Lesser of 60%of the assessed value of the homestead or$48.000
Notwithstanding any other provision, the sum of the deductions provided in iC 6-1 1-12 to a mobile home that $
is not assessed as real property or to a manufactured home that is not assessed as real property may not
exceed one-half(1/2)of the assessed va : of the •a ome or manufactured home.
Signal e o Auditor Date Sirdgo ri ri a yea 1
41 4 Aril i /01N a 411, i
3 & G./ 6 0 .
DISTRIBUTION: Original-County Auditor. File-Stamped Copy-Taxpayer
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