Homestead_EtcovitchCLAIM FOR HOMESTEAD PROPERTY TAX �� FORM Y�R
CREDIT/STANDARD DEDUCTION HCto
` � s�a+e r-am sa�3 (rm � �-m>
Preunbed by Ihe Depariment ol Local Govemment Firiarce
INSTRUCTIONS: See reverse side /oi filing insWcfions.
� i••�i � ry,i� uci r � i�r. n a��� certi{y Wat on [h 5`t d'81y ot MnarnchQ. 20
I(We) oxupied as our prinapal place of residence the fdbwing described real property fw which a Hwnestead PropeRy �Eretllt ��t�y daimed:
I(We) owned ❑ Are buying under tontrad
Have a benefidal interest in ihe entity Ihat is IiaWe for the propeAy faues on fhe property and that oans the
If buy'v�q on conUad, Fee Simple wmefs nama
Recordefs of6cs where canUad is racorded
Counry TamsNp
Record number � Page
Tanng disUicl (city, to»n. (amship)
Is Ihe property in queslion:
❑ Real property ❑ Mobile Fbme (IC 6f.1-7)
If arry portion of ihe residerrtial swctura w Ihe WM na ezceedirg or�e (7 ) acre that im�ately wrtounds Iha� stn�cWre is used W produce Inwme, descnbe the use and portion
oFihe p�opeity ulifized tu produce inmma. r-\ n
1 JL\. �1-3-II f.�5�-
�— ��.n.is
�_ � . . .. . .
�� ..
Land not exceedirg 1 (olre) acre immediatey ` � �- ' - -�''� �
y F �.r
surroundirgresidentialimprovements. (�� _ ,, r.-.� '
�. i�>>i,Y' �`l:'I
�}�18f �2fld �2� `� � ;�'��{ �i'.i..:.
Tdal larrcl (line 1 plus line 2) (g�
Dweliirg (4)
Residential improvements or Mnually � - '
Assessed Mobile / ManufacWred Home - . - . ., � - ..
Ga2ge (5) . . . . .
Oiher improvements (5)
Ttlal improvements (line 4 through line 6) �7�
Talal value (line 3 phs Grre n �g)
I hereby certity Ne above is true, cortea, arM SignaWre of Asxssor Date signed (mmth, day, yea�
complete.
Vaifying adion - SignaWre of Auditor Date signed (mmN, day, yea�
`� — P81' 20 — 45,000 for 2007 pay 2008 42,000 for 2010 pay 2017
Lesser of 12 qq,ppp for 2008
Homestead Valuation P�Y Z009 4 �•000 for 2011 pay 2012
« 43,000 for 2009 pay 2070 40,000 payable after 2012