HomeMy WebLinkAboutHomestead_Schmits (8)�,� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fwm 5473 (R6 / 4-03)
PreStribed Dy Ne Department of Local Govemment Finance
INSTRUCTIONS: See revcrsc sidc lor liling inslruclions.
I (we) \� ,/1 I U � � ��XJ �./V 0 ' ��� v
I(We) occupied as our principal place of residence the following described real property for which a
❑ I(We) owned ❑/ve buying under contract
, Have a benefidal inlerest in fhe enfity that is liable for the property taxes on ihe property and fh;
If buyirg an conVaU. Fee Simple ownefs name
ofica where tontratt i5 reCOrded
County
FORM
HC10
YEAR
certify�UJa3-o�th� 1�a� of March, 20
�stead Property ac is hereby daimed:
conVaU.
Record number � Pa9e
/� umbe�r% �Q Legal dyq5CL�pJ.p,fion /, Is ihe propertrry ��in queslion: �
! — O� / 8(� ' -/� � �eZ — �J ' � v l.p,Real OrapertY ❑ Mobila Hwno (l.C. 67. f-7)
� �
pwtion of Ne resiEenlial structure w Ne land not exceeding me (7 � ace that immeEiatety wrtounds lhat swcwra is used b produce incwne, describe Ne usa antl ponion
properry util¢e0 tn prciduce inwme.
/� � p�� .
�' i Ii// �� �11i �i
CouNy
I hereby certify the above statements are We, corted and complete.
(num6eraM sfreet, ciry, state, ZlPcode)
�.�`j� �`NM1�.,l'I`^>CYY�2�"`C � S �r "a
�^�{ �.�`,�..'�'�-�' �TRUETAX s� ASSESSED�VALUE �HOMESTEAD-� � NON±tES�OENTIAL �j-4i+
�.�,� aASSESSOR�U�SaEONLY�� j� �' V/LLUEt�� ""ATt100,6.OFTTV � yVALUE�_ ti,, VALUE�'�4r�
.,� 9��:. h � ufiai� ,.4P�'r..z,... '�`� � .5...� :. _ � �"t�T ...+r� ��u.`p`�l.'-u�:`. �a�..�.- i��
Land not exceeding 1(one) acre immediately � ;;.�3,`-.K, ,a�`�;f°' .F.�-{��'3�,�
surrounding residential improvemenfs. ( � �� �'a';�"2� � -�'�''
..... r' �a. `'ik.'-'�`�� �,Y`.
Other land '� �� �� v
(Z) F��i{i...���
Total land (line 1 plus line 2) �g�
}` Yu �^<
Dweiling (4) ^� f+., �` � a.��»��43�3���--�1
..,.- aSTF`�'�,
Residential fmprovements or Mnuatly ,��
�`-_��-.. ��� �.'��-.�-���
0.5sessed Ma6ile / Manu(achued Homa Garage (5� � �,����� �;a'�'��'�i�.'x .�'�r�� `r
rYY-.,ua.�' ,.��...il�'ro3��...e{%�'
� �"' "� i
Other improvemenls (6) ��,s s��=
Total improvements (line 4lhrough line 6) (7)
Tdal value (line 3 plts line n (g�
I hereby ceAify the above is W e, corred, and Sgnamre otnssessor Date signed
complele.
Verifying action - Signature of fwdiWr Date signed
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