HomeMy WebLinkAboutHomestead_Schmits (13)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5173 (R6 / 1-03)
P�vaaibeE by the Departnmt d Local Gove�nrtwnt Finaxe
INSTRUCTIONS: See iewuts alde bf0rp iu0rudiona
FORM YEAR
HC10
I(We) �grufy t�t go.wa lsC'�ay of March. 20
1(We) occupied as our cipal place of residence fol ing described real property for which a Homes�tead Property i�r�i{,tiy�hereby daimed:
❑ I(We) owned ❑ Are buying under wntract F EB L�1U0.
' Have a benefidal interest in the entity that is liable for the property taxes on ihe property and ihat owns lhe pmperty or is buyjrlgunder a conVaIX.
I( buying on conVaq. Fee Simple owners name
Recordels afice
Caunty
Tuvnship
Record num�er � Page
Parcel nu�mJ/�r L scripGon q g - Is the pm rty i question_
�/ -oai9a - � ���� P� J —'�d �Real DroOaM ❑ Mobila Hano (I.C. 6f.1-7)
If any portion ol the residenllal sW cWre w the land nd eaceedinp rna (1 j ave ihat immetliatety wrrounds Nat structure is used lo produce incwne, desttibe the use antl portion
ot the property utif¢eC tn produce incoma.
�—oi �a����ifi
' -�'� ' ��'�'"�`�"���'�� '�--;'��"TRUETAX�� ASBESSED��VALUE �+HOIdESTEAD�F`"� NO� SIDENTIAL �
������A5SESSOR�USE ONLY�����f�� �' ;VALUE��� .qT 100%'OF.TN� � � VALUE,� ��i-� cg`:y/LLUE% ����
� a "�.'sG$��F:�:...: -+_- __"`' �s-.-.,..,.,,..-�.,v..c.. .c.�t`F�� �e.�ln..� ..�:l.ti.i5:�
Land not exceeding 1(one) acre immediatety ����° fy��„ .� .� '+�€''�.`Y�
surrounding residential improvements. ��� : y �'��'�i�''�� �",.�rt'���
Other land � �s� � �
(2) 5������o'.�`�
J./ . J.`6�`
Tdal land (line 7 plus line 2) (g�
Dwellin q �� � ��`��e�-i����
�ResidentiallmprovementaaMnuaDy 9 " "��"������Y��� �
Aexased �b68e / ManufacGaed Hane � ;�.�>, '��,
Garage �5� �g,E�.�'�""`C�':f,:��r s
�ai'��'�+Ya3 5��4E3+a���
y a�•� i
Other improvements (6) ,,?�,-� �'�,.r� ��• ��
:='.�-�4�. 'eez:c��
Total improvements (line 4 through line 6) (�)
Tdal value (line 3 phs line � (g�
I hereby cerfify the above is We, coned, and Signature o(nssessor oate signed
complete.
Velitying action - SignaNre oflwditor Date signed
�'���`mr�'t,��:i��.�'�`�`"eti`��.'��,�?�,�,�L3�f�5TANDAR�:DEDUCTION ALLOWANCE;.S•�b'��'�...��"-,'��,._�`,�,;;�s-,-�,"'t°.�1�,�����$'i3',D,,,'��:�K
20 _ Pay 20 _
Lesser of 1/2 Homestead $
Veluau0n or Y.i5.000
Signatura of Audila ' Date signed