Homestead_RidgeCLAIM FOR HOMESTEAD PROPERTY TAX �� � YEAR
n• � CREDIT/STANDARD DEDUCTION FORM
`.:. .� Stafe Fortn 5673 (R817-07) HC 10
Prescnbed by Ihe Dapartmerit of Laal Govemment Finance
INSTRUCTIONS: See reverse side fir filing ins Wc6ons.
I�(We) �``/ � certiry tha�fi'the YstUa�iSt1cfarch, 20_
I(VJe) occupied as our prindpal place of residence the following described real properly for wh' Homestead Property T�c Cre/dlil�/is h�ereby daimed:
�-� I(We) owned ❑ Are buying under contraG �%si � ti+�J�
C/ U
� Have a benefidal interest in the entiy ihat is liable for the property taxes on ihe property and fhat owns th� �Mgp81ffi}7�Bontract.
It buying om m�Vact, Fee Simple ownels name
where conVacl is recortled
Tawnship
3a�es�tion
Is ihe
Racord number � Page
❑ Mobile Fbme (IC &1.7-n
If arry poAion of 1he residential sUUGUre w tha WM not exceetling one (7) acre ihat imm�ately surmunds Ihal structure is used to produce inwme, describe Ihe usa and portbn
of 1he property uG5zed to produce inwme.
�_ � � � .� • �
�i'. •
Land not exc�rg 1 (orre) acre immediatey '.,: �, " ,: - � '- -
(�) ' '`�
surrounding residential improvements. - ;-���, . ; ,
Ofher Wrk � (2) � ,.��`-- _ ti. �
;."ri}. ::....<:. �,.
Tdal land (line 1 plus �ne 2) �3�
� � 1 . .� � _, _.
�V/E�I ' t'V i .. �.: t `i' . . _
Residential vnprovements orMnually � (4� `'�''%" _?`>-g`«.^ ,'' `'
.�o �t'...sy',°.
ASSCSSBdMOW1E/M3nuFLC4l2dHon�e Gaf2B �"'c��ii�r.`>i.tr<.+'�.
9 �5) '?O.::L��•: :...., .
`i:l
Oiherimprovements (6) - - - --
Tctal improvements (!ne 4 tl�rough Gne 6) ��)
Tcfal vatue (1'u+e 3 plis line 7) (8)
I hereby certify the above is We, corted, ard signawre otAssess« Da�e sgned (mmN, eay, yea�
complete.
Veri(1'ln9 adion - 59reWre of �br Date signed (rrpnfh. daY. Yea/)
� pay 20 _ qs.ppp {or 2007 pay 2008 42.000 for 2010 pay 2011
Lesser of 12 qq.000 tor 2008 pay 2009 41.000 for 2011 pay 2012
Homestead V�uation S
� _� 43,000 for 2009 pay 2010 40,000 payable after 2012