HomeMy WebLinkAboutHomestead_GeorgeCLAIM FOR HOMESTEAD PROPERTY TAX
, ^ � STANDARD / SUPPLEMENTAL DEDUCTION
State Fortn 5473 (R72 / 6-09)
�� � PresuiDed by tha Department of Loral Govemment Firence
INSTRUCTIONS: See reverse side for filing instrucHOns.
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I(We) ce'ty that I(we) occupied as my (our) prindpal
place of residence or am re) buying the follovnng est a P rty Tax Standard Deduclion is hereby daimed
under mnVad on ihe date ihis appliration is filed, (tlate of fiing):
❑ I(VJe) own ❑ Am (are) buying under recorded conVact
❑ Am (are) enlitled to oaupy as a tenant-stockholder of a coopereUve housing corporation
� Have a benefldal interest in the Wst or the right to occupy the pmperty under the tertns of a qualified personal residence trust
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So�l Smurty rumter da'vnant (kst fise di)ds)
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Record number Page
tawn. rounshiP)
Parcel number Legal Oescription d• O �� Is e p�operty in question:
(.c) /J [t1 /D - .3 —/ O ��� vrovam ❑ MnwOy assessed rtro6ile home (1C 6-f./-�
If any portion ot ihe rasdenlial swcNre or Na land not exceeding ane (1) aae Ihal immetliatey wrmunds ihat swcWra is use0 10 produca incorne, desriibe Ne use atb portion
o� me wccem � m v�e�,ce �.
�. G -�9-io - �ov - ooa .a 33 - v �.s--�
Caunry
Township
I hereby certify the above sta[ements are We, correct and oomplete.
J AEdreu(numDeiand5heef,riry,stefe,aMZlPCOtle)
P c��9 S ,�7t.E �� �i�nc
Land not e:ceeding t(one) acre immediatey I�� �
u�vnimAinn msiAnntial imorovemenls.
Otherland
Total land (line 1 plus line 2)
Residentlal
Auessed N
Other improvements
(3)
Dwallin9 (4)
Garage (5)
(6)
Total Improvemen6 (/ine 0 through Ilne 6)
Total valua (line 3 p/is Ilne �
I hereby certify ihe above is true, correct,
and complete.
Vaifying artion - SignaNre ot PudROr
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(0)
Sigrature of Assessor
Counry
20 pay 20 Lesser ot 60% ot the assessed value of the homestead or $45,000
NofwiNStarNing any oNerpro�ision, Ne sum Nthe deducfions provitletl in IC 61. f-f 2 ro a mo6l7a fame INet ic
nat assesseC as ieal propeM or to a menulurlured hwne fhef is nof essessed es reel pmperty meY not exceed
one�haH/f2) d Ne assassed rdfue ol mobi/e �ome w menutarlured home.
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6 9.
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Towr�ship
Date signed (monN, day, yee�
Da[e v9ne0 (rtronN, tlaY. Y��