HomeMy WebLinkAboutHomestead_Perry (3)�.} CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fwm 5473 (RB / 4-03)
Prescribed by the Depariment of Local Govemment Finance
INSTRUCTIONS: See reverso side Ior Iiling insWClions.
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ocT z o 2003
� �e) �' � cert -the'/eLb� � I1��
I(We) occupied as our rincipal place of residence lhe (ollowing described real pmperty f r ich a Homestead �e��'Yla<Q,Y�e� t is�l Sre��daimed
❑ I(VJe) owned ❑ Are buying under contract
` Have a benefidal interest in the entiry Nat is liable (or the property taxes on the property and Ihat owns the property or is buying under a conUacl.
I( buying rn conUad, Fee Simple owners name
Remrdefs otfice where wnVact
County
Tamship
(dry, town,
Parcel num r L al descripibn I is the
Oo_ -�2��� �- rl nl �,.�a�-3 -ia
i( any porlion of Ne residentlal sW cWre or the Wnd not exceeding one (7 ) aae that immediatety surrounds
ot the property uu7aetl to produce ifrcome.
/8.67a�.
a�-�9�d-�oo,
that
Record num6er � Page
Real property ❑ Mobile Homo (I.C. 67.1-�
�re is usetl to produce income, desvibe the use and portion
�s
`:x'L��'l3S.-r s�o.u�,.. , . .. - . . � -_ i..,r91..a3+"'e.�iL'�y�,`; � � i'a'y�: �{`
r`� �:,.«.._. co�: µ.—���;;�;�,�,�y{�t�,z`STANDARD'AEDUCTION'ALLOWANCE.�-c:.m�eu`t���s- ". .mg-';?a.�a� ��r'.- ._.,s: +�.���
20_Pay20_
Lesser of 1Y2 Homestead
5
Vauauon w f35.000
SgnatureofAUddw � Datesigned