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Homestead_Mayer (10)° CLAIM FOR HOMESTEAD PROPERTY TAX -- ; CREDIT/STANDARD DEDUCTION ` ' S Slate Fortn 5673 (R8 / 7-07) Prascnbed by Ihe Depar�meirt af Loral Govemment Finance INSTRUCTIONS: See reverse side Ior filing ins6uctions. ._ � `�� � ,''� � � '� II(We) �� � certity fhat on the 1� I5Fa�_ I(We) 'ed as our prindpal place of r nce tlie fWbwing described real perty (a which a Homestead Property TacCre� i' tl�� , GIBSON G �„ I(We) owned ❑ Me buying under contract Have a benefiaal interest in the entiy that is IiaWe for the property faxes on the property and that owns the property or is buying under a contrad. IT birying on wniract, Fee Simple ownels tmme Counry Pa�cel number Twmship (cQi: rown. Is �he i��- �rc �r_ a� - 3 -�r i tt arry paUon N �he resideMial siruaure u Iha land na exceedirg orre (i) xre Vut im�atey wnounds ihal af Ihe propeM1y uli6z� In produca inmme. �� O -/�_�G-�7"�-Ooa. /��-�01�" Recwd number � Page al properry U Mobile Home (/C 6-1.7-n is used to produce Income, descriDe Ure use end portion ,. , . . .. . , „.. Land not ex�rg 1(o�re) acre immediately Us ?;., `� wrtounding rasidential improvemenls. (�� �; �,��.. r _ ,.,,�-._." :-_ :. Other lard �p� '`-"� `;3:'i'?! :';:'. Tdal IarM (line 1 plus line 2) (3� K t�Y � Dweiling (4) ' - � Residential'unprwemenLSwMnuaily 4",�-� " Y Assessed Mobile / Manutachi2d Home - �� ' :; ,`�`-`k.' , Garage �5) Iz�,,:T �j - ; - r :p : � , Ottierimprovements (6) ., ,-�;=.-:"�,;,_u-..;. tt � �:� �I:=�' :�: •. . -.. ., ., Tctal improvemenis (line 4 fhrough Gne 6) �7� Tcfal value (I'v'e 3 pl's Grre n �g� 1 hefeby certity the above is We. Corted. aM Sigrrewre ofAssessor Oate signed (month, daY.Y�) complete. Vailyinp ectian - Sigrm4ne Oi �tor Date 5igned (mmN. QaY• Y�A p_PaYZ�_ lesser oF 12 Homestead Valuation or signaWra of fwdtv 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011 44,000 tor 2008 pay 2009 41.000 for 2071 pay 2012 $ 43,000 for 2009 pay 2010 40,000 payable after 2012