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Homestead_KruseCLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION ` State Fam 5073 (R817-07) ` Rescnbed by Ihe Departmerd of Lazl Grnemment Finance INSTRUCTIONS: See revarse srde /or frling instiuctions. � FORM YEAR HC10 � i(we> (� the properry or is buying under a contract. If hvye�g om m�Vaa, Fee Simpe o.mefs imme oi6ce whera conUad is recorded Twmship Legal descnplim Taring dislrict (cify, town, Is Ne a �-17- 1 �-�3w-(-i�YJ(�G,-l�LS I If arry portion oi the residential suucture or ihe Wnd na ezceetlirg one (7) acre Ihat immetliatey sureounds Ihat of Ne property uU5zed b pmduce inmme. Record numbar � Page Ym �9��Uon: • LFeai P�PaM ❑ Mobile Home (IC 61.1-7) :tura is used b protluce Mmme, describe Ihe use ard pMbn �_ � � • .� � � ti'. � LarM not exceedirg 1(orre) acre irrmediatery � r rE'��';;%� �.{.:-?;�;: .-''"-= surroundi residential im vements. (�) . ` " �>^'. �::�;s::., _r;� :...: _ n9 Pro :?, .u;.� _ - OUter IaM � _ � �'� �'•s f-�+�• - ' (Z) y.,, <�.-�_z�.:, `; Tdal land (line 1 plus fine 2) (g� r � r:-_ i i . A : : Residential impravements or Mnualy ��i� �4) ' "� .4 � � : ` , _. �' ` Assessed Nbbik I Manu(xWred Home .- ;, Garage �5) , .. .,` � �;r Other "unprovements (8) . . - - � TUaI improvements (line 4 through line 6) �7� Total value (line 3 pljs Grte n �g� I hereby certify tlte above is We, correCt, and Signawre ofPSSessa Date signed (month, day, year) complete. Verifyi�9 adion - SipnaWre M�tcr Date signed (mmN, daY. yea�) ZO PaY Z� — 45.000 tor 2007 pay 2008 42.000 for 207 0 pay 2011 Lesser of 1 R qq.000 for 2008 pay 2009 41,000 for 2011 pay 2012 Homestead ValuaCOn S a � 43,000 for 2009 pay 2010 40,000 payable aRer 2012