Homestead_Hicks,� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
♦ � State Form 5473 (R6 / 1-03)
Prescn6etl by the Department o1 Local Govemmenl Finance
� Have a beneficial interest in lhe entity that is liable for the property taxes on the pmperty and Ihat owns lhe pro�js,�under a contract.
If buying on contract, Fee SimD�e ownefs name
Recorders ofice where wntrac� is recordeA
�=�:"'b::.r "t=�•--. . '�. ^ "'P"�:�=,"t"`:BROPERTYOESCRIP,T�ON�:.,.' .. ,. '
Counry Tavnship T�cing i'c� (uty, fowq to h�
Par I nu r / Le a sc � tion / Is Ne propeny in uesl
6 Cl (O
.. . � �' ;�?.�t�'. " - .
Recora number Page
� - ��^/� Real pmperry U�bile Homo p.C. 67.1-7)
If any potlion ol Ne residentlal sWcture w Na land not exceeding one (1) acre t�al immediatety wrmunds �hat cture is usetl b produce inwme, desctibe ihe use antl portion
ot the property utilized ro produca inwme.
�!I �L r� I�l i�/_ il �wf ' I,'I�
- - .�--� ,_�.. �: _ _ _
:_'.,:.'"t$%G- `•?'.`_�� ^--�•:�a- � �:�PROFERTYOWNED�BYCCAIMANTIN�:OTHER'COUNTIES -� �= -�� �i �,` ==r -
County Tavnship County Township
1 hereby certify the above statements are W e, coned and complete. sig tur vi claimam /� ��
1J�
ddress number arM sfr 1, city, stafe, ZlPcode)
�S f. r n � +� y7 y�
�
lPaa"� y. r�' .ASSESSOR USE ON Y.. - � � TRUE TAX ASSESSED VALUE HOMESTEAD ' NON-RESIDENTIAC�_
.t'.?JUjlt.�t?t:...� =r-f..,,:<f�:= .. :.�-; �� '�� VALUE -' AT100%OF;TTV •,• : VALUE . -�i..�,VALUE: � .r.-. �.
Land not exceeding 1(one) acre immediately 4=�^ "` �"'-`- - �
surrounding residenGal improvements. (� � -� � I
Otherland (p) � - � .-
I
Total land (line 7 plus line 2) (3)
Dwelling (4) � :. i__ .
ResidenUel improvemants or Mnually
Assessed Mobile / ManufaUUred Home Garage �5) �� t- .
Olher imprOVement5 (6)
Tctal improvements (line 4 through line 6) (7�
TUaI value (line 3 pl�s line n (g�
I hereby cetlify the above is true, coneU, and S�9nawre o� wsseswr oate signed
complete.
Venlying action - SignaWre oflwditar Date signeA
'%i± ��.:: �:h,�� T,�,± " -- -.STAN�ARO.DEDUCTIONALLOWANCE-.�: .. �- . - ;�,: -
20 _ Pay 20 _
Lesser of 1/2 Homestead �
v�uauon or 535.000
5
SignaWreofFwdilw ' Datesi9ned I