HomeMy WebLinkAboutHomestead_HardinCLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
State Fortn 5473 (R6 / a03)
Prax�ibed by the Departmem of Loral Govemment Fnance
INSTRUCTIONS: See 2verse side 7or filing insfn�ctions.
FORM YEAR
HC70
3 - �3 - doo �
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I(We) 1Cj�� �.( K/.41��(/GLU certify that on the 1 st day of March, 20_
I(We) occupied as our principal place of residence lhe following described real property for which a Homestead Property Tac Credit is hereby daimed:
❑ I(We) owned ❑ Ne buying under contracf
� Have a benefidal interest in the entity that is liable for the property taxes on the property and ihat owns ihe property or is buying under a contract.
I( buying on conirad, Fee Simple ownefs name
Remrders olfice where conLaq is remrded
r-��-��"o,:c� � "„4 � . �"w'Pr
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County Tomship
(ciry, town,
Rewrd number � Page
/ra%rc�Y� num/cey� � S L I 85tn IOfI` n Is U�¢ pfppC�tlyy�9questio�S: �
�! �ZLI ���+ '� " %/ly �� —�Q p[J Real pmperty ❑ Mob'le Homo Q C 6f 1-7)
H any poNOn of Na resitlentlal sWcWre or the land not axcaeding one (1) acre thal immeaiatety sunounds ihat sWGUre is used b produce income, describe ihe use antl portion
af the properry utilizetl W produce income. rJl�n
� v Ci
�x -i�=i�� os�a�=aoo iy� -o�s
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�:.+�`.et�a�"'�.' �:s`�-r'�'�.'�k�'�w'��'�S�P,ROP.ERTY,OWNED'BY CL'AIMANT;INIOTHER'COUNT
Counly Tonnship County
I hereby certify the above statements are We, conect and complete. Signature daimant
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(numberaM sfreef, ciry, sfafe, ZlPcode)
���'a �� 77a F� .
'����RSu"� 4;Y�4ASSESSOARSr�SEONLY��'� '�3.�-T�'~wTRUETAX �r ASSESSEDVALUE ��HOMESTEA�Di*{{Y-� �-NON�-RES��ENTIAL ��
-uh:'�i_,�..�.G'?F-.66u;};�. ^�rh�-.. _:." _A�,FV-�"�.;,s �;,VALUEa„ .y.,.+,"L ..AT 100%:OF�TfV� �� �.VALUE� :"'�' �''�,`�E�`i.VAI.UEt'�_ o-
Land not ezceeding 1(one) acre immediately '-�v� i,�j' � �, i��.Yt�
c`�'�z v� �
surroundingresidentialimprovements. (�) �`'F;��''y',o� `}"�
� � t�i�`-
Other land � � �K`
(2) s�°�jX���e.�`�3r,
� /� 1::
Tdal land (line 1 plus line 2) (3�
$.�+.R.°y'IT ti ✓�-eGhs`%+'=y;^
� y.�r J—r� iF� Y'�+'�t`v:�fY.
Dwelling (4) � s. - �q�qr�:��
�Residentiel improvements orMnually } �������'' �'^^�-�'��
Pssessed Mobiie / Man�ured Home Garage (5� j��� ����y-������/�`�
Sh-A� 1 �^ i� �
`�i � �c :
Olherim rovemen�s ' -����
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P (6) �• �t" +v--- �
iw .���
s'-.':.,,.i._ a-�h�...
Tctal improvemenfs (line 4 through Irne 6) (��
TUaI value (line 3 phs line n (g�
I hereby certi(y �he above is We, correcl, and Signatura ofAssessor Date signed
complete.
Vaitying actbn - Signature otlwditor Date sgnetl
" "-���=�� `�..r�..�': �t7�st�"��F�`T'.��. > �: `���:STANDARU'.DEDUCTION�ALCOWANCE.:�'.�-'x'�:EC'".:4�':`'m°�''�„m-�.�'�"�tTt'�__=',��vc�'+."A'.�it'"'F�
20 _ Pay 20 _
Lesser of v2 Homestead
Vewanon or 535,000 S
SgnaWre of Audrior " Dale sgned