Homestead_MacMunnCLAIM FOR HOMESTEAD PROPERTY TAX �( FoRM YEAR
CREDIT/STANDARD DEDUCTION HC10
SLne Form Sa73 (R6 / 403) �
� Presfiibed by the Depanment of Local Govemment Finance '
INSTRUC710NS: See reverse side !or filmg instmclions.
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I (We) �f Mth�14�tl�of March. 20_
I(W oaupied as our principal place of residence the following described real property for which a Homestead�Pyro�,perty Tac Credil is hereby daimed:
=(We) owned ❑ Are buying under contract p�! ,Q�
. Have a benefidal interest in ihe entity that is liable for the property taxes on the property and Ihat ov�g��i¢b 0.q,11l�der a wnVaU.
�n wR
I( buymg on conVaq, Fee Simple owner's name
Recordefs olfice whera wnUad is recordetl Record number Pa9e
� k'� :�`#�� �^'' � Hv � V.fi s` �s� a""`-'-�'} �-r' l Gr.`1`---•• i s�'' .v:
.���'„s �,.tt+=::`;�z�.,.<w e-'�w� �'-v�,9 ,�.�PROP.ERTV.OESCRIP.TION��'W'�"„a�-.,,.,�Z'�i,-�'�';f s,�.-`�'�.•.:'F-�y`,Y�;���=.�'t,;
Counry Township Tacing �istrict (ciry, fown. townshiP)
Parcel number
Is the property in
�� �— v a 07 a�� I �%'�r'� �10J � 6� 3��V I �eal Droperty ❑ Mobile Homo (LG 61.7-7)
If any portion ot the residentlal sW dure or the tand not e:ceeding one (7 � aae Nat immediatey surrounds that sWCture is used to produce income, describe ihe use and portion
of the propery utilized m produce inwme. /QG
_ �9_�/ - /�� -�ha � ��:
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_,��. ,,,,.... �y�',: : �- ,�`,�'-"`,{;a- zti';'�.�_;;, �� •�PROP.ERTY,OWNED!BY�CI:AIMANT IN�:�OTHER`COUNTIES [F'..',is_','.�.�,.'� ,-� : . 4.�+��.��,'4�`a=�'� "c5, ,°.s'+�4
County Tavnship County Twvnship
I hereby certify Ihe above statements are true, cortect and complete. �atur lai nt �` �
� aress (num6u ar�d sheef, ciry, stafe, ZIP code) •
'�����' � �r�"`r � � "N"���" ""' � � = TRUETAX�� ASSESSED�YALUE �HOMESTEAD' '�tNON-RESIDENTIAL �
x.. ' �SESSOR-���ONL��^�'.�y7_� ,+R_�'�VALUE�'�'y� "ATx100%.OF�TTV# �=`VALUE�'"'� ��-'s-�?' �VALUE���"�
��H'�i',�. aa. `u"v nrr:-k.�..n�,.�.ss.,_• ,e,�
Land nol exceeding 1(one) acre immediately � ���'' yti�'� y ess,'�*��3 .� saZ��"�
surrounding residential improvemenls. ( � �:t�'�` . ,fr������r��s
�;
Other land ` � " �
�z� �a=�+ , =���
Tdal land (line f plus line 2) (g�
��3`'`?% ` s��.'�`�'�'�z��'.
Dwelling (4) ka F c X•y'""
Residendal improvements or Mnualry ����`'��"�'`�''4""'#�
� °�r:,? .:° y.-='c
Pssessed MoWla / Manufactured Home Garage (5) "`��4�. . - 5:r: ; � -��
'�` '.�w' �_
%=4'i�'� �,'S --
Other improvemenis (6) -� �����,����
,_.i: ,
Tdal improvements (line 4 through line 6) (�)
Tdal value (line 3 phs line � (g�
I hereby certify ihe above is We, corted, and Signamre otnssessor Date signed
complele.
Verifying aclion - SignaWre ofAUditor Date signed
20 _ Pay 20 _' I
lesser of 1l2 Homestead g
vauanon w E35.000
signed
