Homestead_Gregory"'" CLAIM FOR HOMESTEAD PROPERTY TAX
r t CREDITlSTANDARD DEDUCTION
State Farm 5473 (RB I 7-07) .r, —
•� ���s `� Prescribed by Ihe Department ot Local Govemment Finance
INSTRUCTIONS: See reverse side lorfifing instrucfrons.
_ �p FOR� YEAR
� FJF�
AUG 1 5 ZOU8
� M�e) ����bM�Y1��Tif��arch. 20_
I(We) occupied as our prind I place of residence the tollowing described real pro rty for ic a Homestead Property Tac Credit is hereby daimed:
�) owned ❑ Are buying under contract
Have a benefidal interest in Ne entiry that is liable for the propeAy ta�ces on the property and ihat owns the property or is buying under a contract.
If brying an contracl, Fee Simple amera nama
Recwtler's offica where conVad is recorded
Counly Tamship
Tacing disVict (c�ty, iow9, ta.vnship)
Record number � Page
Pa¢el number L escn ti/p��f ��.C� ? Is Ne prop�Q�ygm.,�qu��es6on:
-�'V /v`. � 3 � / �Q I �`ac � ProP�' ❑ Mobile Home ((C &7.7-�
If any partion of the residential atruclure or Ihe land no1 e�cceeAinq one (i ) acre that immediately wrtounds slructure is used to D�duce income, describe ihe use arid portion
of Ihe property WGZed �n pioduce incoma. / %� �
a � � o�
9-i.3- a6G-�o a. �S,S-oa�s'
,_ , . . .. . .
,,... �
land not exceedirn� t(orre) aae immediatey �� �
surtoundingresidentialimprovemenls. (�� � . - . . . , '-
Other land �p� - � _
Tdal land (line 1 plus 1'me 2) �g�
Dwellirg (4) `� � . .
Residential imprrnements a Mnually
Assessed Mobile / Manufadured Home
Garage �5� � �
Other improvements (g) '
Tctal improvements Qine 4 through line 6) ��)
TUaI value (line 3 plur lirre � �g�
I hereby certify tlle above is We, correG, arM SignaWre ofPSSeswr Date signed (monfh, day, yea�
complete.
Veifyirp acUon - SignaWre oflwtlitw Daie signed (month, day, year)
� . - � � � • •
2— PeY 20 — 45,000 for 2007 pay 2008 42,000 for 207 0 pay 2071
lesser of 7/2 qq.00p tor 2008 pay 2009 41.000 for 207 7 pay 2012
Homestead Valuation S
IX 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Fwdita Da�e sk,,ned (month, day, yea�