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HomeMy WebLinkAboutHomestead_WilderCLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION Stete Form 5473 (R614-03) Praai6ed by Me Departrnem ot Loral Govemment Finance INSTRUCTIONS: See reverse side /or filing inshuctions, FORM YEAR � U 1� cio �� �7 �. .�J 2006 I(4Ve) C� /L:�(/tJ certify �hat o`r`the rs`t da� ( March, 20 I(We) occ ' as our principal place of residence the fol owing described real pmperty for which a Homestead �7g�Q}Nf�(41#9374 Aei�tij�imed: � I(We wned ❑ Are buying under coniract � Have a benefidal interest in ihe enGty that is liable for the property taxes on the property and ihat owns the property or is buying under a contraU. If buying om m�tred, Fee Sunple owner's name Remrdefs office where wniract is recorded �=�c- .l.F '4'.S� � �. . _ i%,��l.�r_=�'�'a:•r. e:�£i?,�I �'%s,--�'�N�, Caunb � - . . To.mship Parcel number Is the pmperty �'3'/� � It any portion ol ihe residenUel sWCture w the land not exceetling one (1) aae tha��e� te� surrounds that a� �hg Gra� to produce income. d .T .`�j � � �G �9-��-�/-an.o�� _oaG County Tavnship I hereby certify the above statements are We, wrrect and complete. and Couniy Record numEer I Page Real proparty ❑ Mobila Homo (I.C. 61.1-7) ire is used b produce income, describa Ne use and portion Tavnship ���'�''S� " � "'''�"" �'� �t.=�� '��'TRUETAX� � ASSESSED VALUE �aHOMESTEADz2''E" NON3RESIDENTIAL �� � ASSESSOR�USE,ONLY 7' a �� �`�VALl1Eyw � v� � AT.100% OF-TN � � '' � ���� '' '�� ii'.: .�� �v..s ....�= . 1 ...,'.! �u�uVALUEs�,'�+--� f�� �,;,YALUE �m_�r'F _ yr Land not exceeding 1(one) acre immediately ��i�.� , .�.x �� ,_. ... . , . > .,.. , surroundingresidentiaiimprovements. (�) � ��"�Y..���� Other land (Z� �� > r, � . �,:,.:��-��� '�'�'� Total land (line 1 plus line 2) (3� �: � ''�.:�"���.�„-... -�: •a- -..s Dwelling (4) �����„�p �,�� Residential impiovements or Mnualty .�#� '�. � �- -F 0.sseued Moblle / Manufadured Homa Garage 5 cc,� i�^�*�, �,� ���"' ( ) ��.,a�-a�X:'t�i - � �,- . : ':�''�-''�'1' ` `�,�z. - Otherimprovements (6) ,�A�� �"� �.� x.`�,'4:P== GGa`�-`;s� Total improvements (Irne 4 through line 6) (�� T�al value (line 3 plrs line n (g� I hereby ceAi(y �he above i5 We, tortetl, and Signature ofAsseswr Date signed mmpleta. Verifying action - Sigreture oflwditor Date signed ��'x�.�±%�` �3=�}�x"��'%�'.����'-''—`STANDARD:OEOUCTIONALLOWANCE_�'�*'�.a���'4`b�*?'��*��.�°��, _ __ 20 _ Pay 20 _ Lesser ot 1/2 Homestead ValuaLOn w S35.Wp 5 Sigreh�re of PuEilor " Date signeA