Homestead_Meyerrt, CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
State Fwm 5473 (R6 / 4-03�
Prescribed by Ne Department of Local Govemment Finance
INSTRUCTIONS: See reverse side Ioi liling inslnicfions
I(We) � w—' � certify that on the 1st day of March. �2n07S'�
I(We) upied as ou p'ncipal lace of residence Ihe (oilowing described al property fo ich a Homestead Property Tac CrediPis here9/ amttRtl:
/
I(VJe) owned Ne buying under contract � � (�./�%
Have a benefidal interest in Ne entity that is liable for the property taxes on the pmperty and that owns the property or, is buyiog under a cantraU. !
,�a�' FORM
HC70
YEAR
if huyinq on conVaa, Fee Simple awnefs name
Remfdels office where conVaq is recorded
Record number � Page
County Toxnship T�cing dislrict (dty, ( to nshi ) --�
n -ro^ f�� O Legal descnpUon Is the property in qu ��
1
(7C Real v�operty ❑ Mobile Homo (I.C. 61.1-�
N any portion of the resiCentlal sWcture or Ue land not exceeding one (1) acre that immetliatey wnounds lhat sLUCNre is used to produce income. desaibe the use and portion
ot the property util¢tW tu produce inmme. �
-� i i iu — inu —
County
I hereby certify the above stalements are We, corred and complete.
I
sdres;,fny�nber and streeL city, atafe, ZIP code] ,_ �
Land not exceeding 1(one) acre immedialety
surrounding residential improvements.
Otherland
Tdal land (line 1 plus line 2)
Dwelling
Residentiel improvements or Mnualy
Assessed Modle / Manufactured Home Garage
Other impravements
Rlal improvements (line 4 thmugh line 6)
Tdal value (line 3 plus line n
I hereby cert'dy the above is irue, co�eG, and
complete.
Ve(itying aclion - Signalure o(Putlitor
i�)
I21
(3)
(4)
(5)
(6)
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(8)
Signature ofASSessor
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of claimant
Date signed
Date signeA
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g�v�-�,s:.�''-�s��" r,.'s�i�.'•'�4^..�.�'#.`-�,�m,�;STANDARU:OEDUCTIONAL'LOWANCEt�.��",,'^-r�':us",�..",^�;�?;;�`tt,�'"c�iz��.y``�-���„r�Fv'�'�`,'i��;�'_``,t�
20_Pay20_
Lesser of t/2 Homestead 5
vauauon w 535.000
Signatura of Auditor , 1 Date/iglf =
\0 1 r� 5-0
v�._i ..