Homestead_Schmits (10)�
°' � CLAIM FOR HOMESTEAD PROPERTY TAX
b - = � CREDIT/STANDARD DEDUCTION
suie Fom� sa�a �rta r �-0»
•� ,��. � Rescribed by �he Depariment of Lo�l Govemment finance
INSTRUCTIONS: See reverse side (o� fifing insWctions.
�
�(we) \ N 1'lilV.11"1 J �EllAl I�LIL► 1�- V�-1lJUU1� N(..�Sl �erG
I(VJe) occupied as our prinapal place of residence the following described real property for which a Homesteai
,^ I(VJe) owned ❑ Are buying under contract
Have a benefidal interes� in the entiry that is liable for the property taxes on the property and that owns Me
If bryvig om m�tracl, Fee Simpe rnmefa rtame
Rtr,orAeis olfice where conirac7 is recorded
Tamship
Tacing distnci
Is Ihe OtoDeM ut
If afry portion of lhe residenlial structure or the IaM nol azceeding arre (1) acre thal immedately wrtounds Ihal
of �he property Ni6zad tn pmduce inwme.
FORM
HC10
YEAR
that on Ihe tst day of March, 20_
Pro0.a�n7ar,Cm�dC���ereby daimed:
IVUV G
a contrad.
Record number � Page
property ❑ Mo6ile Home (IC 67. i-n
used ta protluce inmrtre, describe the use and portbn
�_ � � • .� • �
�i'. •
Land not ezc�ng t(orre) aae immediatety � -"� ' '
surroundingresidentialimprovements. (�) . � •i �.�� . .. ='.-)
Ottier Wrnl (p� ' - ' .
Tdal land (line 1 plus line 2) (g)
Dwellirg (4) ' ' �. � • � - ^
ResidenGal improvements w Mnually � �
Assessed Mobile I Manufactured Home - . `
Ga2ge (51 _.'�, r—.-' - • ..
Other improvements (6) �
Tdal improvemenls (line 4[hrough line 6) �7�
Total value (line 3 plls lirre � (g�
I hereby certify the above is We, correct, ard Signawre oinsseswr Daie signed (montn, day. yea�
complete.
Vsifying aclion - Sigriature of Auditw pa�¢ signed (monff+, day, yea�
�u _ pay 20 _ 45,000 for 2007 pay 2008 42,000 for 207 0 pay 207 7
Lesser of 1/2 qq.ppp tor 2008 pay 2009 47.000 for 2011 pay 2012
Homestea�i(aluaGOn $
,,, n/ 1 43,000 fo�2009 pay 2010 40.000 payable aRer 2012