HomeMy WebLinkAboutHomestead_Stevens(�A�CLAIM FOR HOMESTEAD PROPERTY iAX
CREDIT/STANDARD DEDUCTION
� Sute Form 5473 (R6 /!-03)
Presfiibed Dy Ne Deparimen� o( Local GovemmeN Finance
INSTRUCTIONS: See revcrsc sidc /or /iling ins6uc(ions.
FORM 1'EAR
HC10
�i� " � �� �.
k li �� r� J �;�
��e) � certity that on the 1st day of.March, 20
�` /i
I(We) occupied as our principal place sidence the following de �b d real property for which a Homestead Property Ta�c C/redit is,hereby daim d:
❑ I(We) owned ❑ Fve buyi under contract �—�-�-u�"✓,!j•J'7��"'`��
='�$���1,'l'i�ylY. ,��nr�-
' Have a benefidal interest in the enUty ihat is liable for the property taxes on the property and Ihal owns lhe property or is buying under a wnVaU.
If buying om m�irad. Fee Simple owners name
Remrdefs oifice where contrad is recwded
�s�`�t-�.'�`_-'�'s+��-'�'>?h��-�...i'c!*t� �"F'�`�
Couny � Township
Gislrict (dry, town. townshiP)
ReWrd number I Page
Parcel �mJ�)er� �I Legal description Is the pro in queslion: �
U✓ �] Real property ❑ Mobile Homo (I.C. 67.1-�
If any portion o1 �he resiCendal strucwra w Na la�d nd ezcceAing rne (1) aae tAat immedatey wrrounds that swcwre is used b produce income, tlesaibe the uu antl pwtbn
of Ne properry utiaed b pr in �
� ��-�'�°= D CJ
Counry
-o3DU
Tavnship
I hereby certi(y the above statements are We, correG and complete.
AAdreu (n M street, dty,
, ���
- �ot �
Township
����9'.z-�`i<^r^�?`�J"'���k � . � .. . � . _ x � 'a.>s•x. - �ss .��
�F� �xA5SES50RlJSEONLY� •3 2t�"" TRUETAX�r.� �ASSESSEDVALUE �HOMESTEA� NON-RESf�ENTIAL s�
�x-i �. .?� �- � fX"r �VALUE,;Y'-��,"°" AT�700%TOFifNT �YAI:UE�� ��'�"�:'VALUE�'��;.��
� ,a�<?��':?�:.G,. �1� ..�� �s'"f.i�rs � ..3. �_. �...,v_.u.,:..._._ >� cer.-w. �K..
Land not exceeding 1(one) aae immediately �� �'"� t�'����'�
suvoundingresidentialimprovemenis. (�� �x ��' `' � `��,dj,`���€;
u,l:'�i'L=�, a e.>- .�s. s
A' `�2, 'i '^S�,tR�'.
Otherland . (Z) `j�,�' ,.�;:�' �
,::��
Tdal land (line 7 plus line 2) �3�
�t , �p� �"'�
Dweliing (4) � ��'� �' a, 'rr� '�"�
Residential improvemenfs w MnuaOy �x�2`���' ��
Assessed Mobile / ManuFac9ired Horrre Garege (5) ��L�''�, y �-cc�`
�����
Y 3�
Otherimprovemenls (g) � '"°-
��;,:
Tatal improvemenis (Irne 4 through line 6) (�)
Tctal value (line 3 pl�s line n (g) .
I hefeby certi(y Ute above is We, corred, and Signature af Assessor Date signed
complete.
Verityirg actbn - SignaWre of Puditor Date sgned
20 _ Pay 20 _
Lesser of 1/2 Homestead
vauaUOn a 535.000
SignaNre
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