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Homestead_OnealCLAIM FOR HOMESTEAD PROPERTYTAX CREDR/STANDARD DEDUCTION s� � s�rs ca� i sos� Preaobed by Me DepeMienl ol Lool GorerrmaA Friar�m INSTRUCTIONS: See ieverse side /or filing ins6ucfior�.c. ...�;. y. , . ... . . _ ..:^t� v u r,r: "i . .. . ._ . -: CBtTiF7CA71 �� . FORM � �R � HC1 I(We) � � cerli(ylha�t�o�' e��a{Marcfi,p_ 1(We) ocapied as prindpal of resider�ce the fo8owirg descnbed reaf property for irh a Hm�a1�lb�yh�c`C�by daimed: �� (We) owned ❑ Me buyuig under Canhad Have a benefidal mterest m tl�e entiry that is liable 6w C�e p�vpeAy fm�es m the popaty and Ciat ams Ne poperty or is buying urMer a oon4aeL ;.�F:•+i: ,:;_:'s ;;1.�•. - .* ,'; M Gq'v�8 om m�h'act`Fee Sirt�le owriefs reme � f�tirdals ol6fa whae ml�ed'u'emdad _. � ,.,t .�.�� �. �._.._..� _. '; arsF a.$ nt r �,;ti.i'. Canly To1rtNdp wuur, nw�:r � e ; i: Tmug di9lict (rX; tn�n, tornafip) ! Remd numbar I Pege Parcel nerma L�gal desaiptim Is the piaparty in q��astion: � - l`l - � S - `l o - ['� o a. . a o-1 - � '1..,0 �� � ❑ �b � c,.�. s,.,-n It arry porBw� of the �idardial sUU�Aae aI fhe land nal m¢eedirg ona (,> aoe Mat:mretfa0ely surtam� tlml �e is uaed b P� nmrie. desame the �ae and ,oition af Ne prape�ty uLf�d b piaduce vwm�e. . _... . . ., . . . . _..,- . . . '� "'� � , .�. �.:'3'PROPEIiTYOWNm'�BY:CLAOIAMT.dOTFIHtCOUNiff3 '�"'��' '': .r.1.�,?i�+°� --„ �.:� 1��'"� .^ .,;-t '?c„„Y' � '•�x. <x�.;,;Zf.z , ti•, Counry Tawnship County Township I hereby certily tAe above 51a�t5 ere true. carred ar�d canple6e. � � r N� � c on: �w z8 �� 2 Z _-o O S a u f-Ll /'�'� c c�ort —� f� .-.: �. "'c . �y t�t�..>•� 71rilETpX � � .,.. (��,,� � :`��k�,� NONatESmEN71AL���� > .._o�'� � r .ASSESSORUSEO?ILY. .� � ; . :3�.`r•4�^�i �: y PVALUE;ffi, v � . �AT:1�. j�^'j� 1 < ��� ri��t�'4dVALUEr'��.,�r'".�'{�' Land not exceedng 1(one) aae �mne�ately V r,.'t{rr�`�'�f x'd-'�:%'�,, r�s4; i�ih'�`�i s�aro�aMmgre�de�rtall'r�provert�enis. (�) � n^ '' � ,, 7 ak�w.�`��',ra.����t:i:r;�c"�i�L'��; QU�erlard �y) � I .`��. � I �� Td� tard (li�e 1 pkrs !me � ig) DweRng (4) '�''�i Sro�`����•.<,�t�r �,y'.',�'��o ResAential'vnprwcy.ients orAnrwafly } s � .v - x..l �.��5'' flS�50d MOblk � Mdf' Nt�.8fbl0d �i0f11@ ' -JY'Yt '� �I � 1"�' ! !, �j �i Garage (5) r "f F �'� �r'�Y�5 ?t.t�`e.��,;�',�'-`' ��a� . .rsy��F�v+�z'F' ` <�S' # a �'+ �1%�`x � �...: tr a.. OU16f vnpovertrents (g) S , a b f r s'�; .r ..� Tdal ur�ptovemertls (6re 4 tluou� fine 6) �� T�I value (I'me 3 p7es 6ne n (g) I hereby certify the above is true. mred. and Sier�+e of �nr Date sig�ed �e 1A0iryug eaim - Si�muue orN�mr Dam sipned .. s.9�.�h, 20 _ Pay 20 _ Lesser of 12 NorteSead v�� or s3s.000 s