HomeMy WebLinkAboutHomestead_Williams (14)' CLAIM FOR HOMESTEAD P.ROPERTY TAX
4 CREDIT/STANDARD DEDUCTION
t ♦ State Form 5473 (R6 / 4-03)
� ' Prascribed by Ne DepartmeM of Local Govemment Fnance
� � INS7RUCTIONSi See raverse side 7or filing insfmctions.
�.a�:�- v. f�.;��>., ,- ���-�;. �=-w" t
-- — - FORM �J YEAR
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FIL
<:�?�}k�H�. '-:-<t�.>''1�'.�,`�^vF- •-r"'�'is>. ;rr-� L` �.'}'.F�iCERTIFICATunJ�nitMenr�,:,•� ° ` •_:. .... -.r._, .-.. .. .
._.. ' �:- x.- _,.f' �•`:�.
I(We) ' • ',(�he 1st day of March, 20
I(We) xwpied as our prindpal place of residence the tdlowing described real property for wh' a�io t d Prop T�c Credit is hereby daimed:
�' �5��� UNTY qUDITOR �
(We) owned ❑ Are buying under contrea
Have a benefidal interest in ihe entity thet is liable for the properry texes on the properry and that owns Ne property or is buying under a conVact.
U buyinp on coritreq, Fea Simple ownars name
Recordefs ofllce where conVed is recorded
�+�N Tnxuhip
Palcel number L da
� _ �O � ' �Ei
I( any portion of Ne residantiel stucNte or Ne larq �wt
ol Na property utllfzed to p`otluce inmme.
p one (1) aae Nat u
S`�� �
Counry I Twmchip
I hereby ceNfy the above statements are We, cortect and complete.
AdEress (number and sUaet, tiry, atare, ZIP wde)
number �Pege
tl15b1G (C�I ; IOwn, tOwnShip)
1
Is Ihe property In question:
ea�O�PertY ❑ MoWleHOma(I.C.67.f-n
surtoundt Ihat s c4ire is used to produce incoma, describe Ihe use anE portion
0
+'"'��� a� �'��'�yx�� �'�" �'��=� r- � ` � ASSESSEDiV/1LUE HOMESTEAD "'' �NON�RESIDENTIAL r
��"'�"°�`ASSESSOR USE',ONLY'a`�� "° ,.'*.: TRUE TAX�«yy, y ?�{ � R
. �= ��` e',� +� si, vs +^��.�`3 �*,� VALUE•tw"`�"'� tAT;100Yo OF s?':VALUEi"-� a� �.�`"vr �?'s .VALUE
's+..�-.�._.bs va_vYz��"*..,.x_:�tx.r�z:.a v,v..,�.v. .,.f.,_� :TN t' iJ.. �M'.,. ..�'�.-:,��' _
Land not exceeding 1(one) acre immediatery :;£ � Fi ,,,. K�"s'r �{ tt �
. surrounding residenlial improvements. (�� • .�:� � ti,L �sur� �„+�_ +,i„'x,r„�.
Other tand �2� _� _•`� �? ;... z3 �ali: _
.1-�;�"''� _
Tatal IarW (line 1 plus line 2) �g�
:F i � d
Dweliing (4) =°` 'i'i'�; _� .�`� -�
Residential improvemenLS or Mnually ; �.x ... �.,..;..,, a.. ?�� '�s,: �� .
Assessed Mobile / ManufacNred Home «^�`� � � � - ` -
Garege �5� 4;1` t . '? � ,�,T Y '.
:�
l� P r :
:s'-3+y.-�.li..,s4�' r",-:.�t�.,v:,a.:.
O�perimprovements (6) 5, .�«
, l+
TUet improvements (line 4 fhlough lirre 67 (��
Tdal value (line 3 plrs line � �g�
I hereby certify the above is We, correct, and � Signamie o(ASSessor � Dau sipned
complete. �
Veriymg aWon - SIBnaWre of Auditor Data signed
`"�� �' �7r�:?"4' �;b?�:"�r`�'^�a'�'��?^z�?'aSTANDARD�DE0UCT10NALLOWANCE : - .i_;-;�. '�-`-.'`.
20_Pay20_ -
Lesser of 12 Homestead
Valuatlon a 535,000 g
SipnaWre o(Puditw Date signed
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