HomeMy WebLinkAboutHomestead_AlstonCLAIM FOR HOMESTEAD PROPERTY TAX FORM �
_ STANDARD / SUPPLEMENTAL DEDUCTION HC�O
T State Fwm 5473 (R73 / 12-09)
�,� � Presaibed by the Department of Local Govemmem Fina(xe
INSTRUCTIONS: See reverse side hu filirg insfniGions.
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�(yye) � certity that ) ied a� io 1 P Pa�
place of resWence or am (are) buying the following desuibed real property for which a Homestead Pmperty Tax da y imed
-•�rWer contrad ai ihe date this appliption is filed, (date of filing). I(We):
Own ❑ Am (are) buying under recorded conVSCt JUN 1 2 Zp�p
� Am (are) entllled to occupy as a tenent-stockholder of a cooperalive housing corporaUon C� ntiytrJ V
❑ Have a beneficial interest in the Ws[ or �he right to occupy the property under ihe tertns of e qualified personal residence .
❑ Am (are) the shareholder, partner or member of Ne entity ihat owns the property. GIBSON CO
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Nama d t (legal neme)
Sodal SeanitY nwMei W ( � Issu4g State
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Name 01 dei nts spase (legal rame)
SorJal riry numbar of dahnanPs spousa (last fi�e dgU:) Otivers fiteme / Identifintion / Oiher `wmber � IssW� Slate
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tl buying on wntra4 Fee Simple owners rame
Recorders oRice wM.�e conirer� ¢ iemrded Record rwmber Page
..�. . � . �
�nry TovmshiD Tarirg EisUiri (dty, rown, rownshiP)
�Pa/i�mi n ber ^► ^ Legal desrriPiion Is IM ryoperty in Ouestion:
Qo �� � Ol � V �� ❑ Real proprlty � Anm+aOY assessed mob0e home (IC 61. f-7)
II airy portion of the residentlal structure or Ihe WM not exceeding ona (1) ame ihat immediatety surtounGS that struclure is used to pfodum ir�come. tlesaihe the use and pwtion
oi Ne property utilized b produce Income.
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County Township Counh Tv.v�ssfup
I hereby certify the abova statements are We, correct and complete. S' cu aimant
(numDer eM stree; dry, sfate, a LP codaj
lI U Soc� c SdcKLE �
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Land not exceeding 1 (o�re) acre immedlatey �� � � „y > ��''�,'Y.;}�% �4 � �;:�,
surtoundin resltlentlal lm rovements.
Other land (2) '� `"��_..� �;�'���
Toml land (li�re 1 plus Ilrre 2) (3) G�
? �. � �. f ..Y 3 Y°��A�i. ?�Fl
Reside�rtial Improvements or Mnually ��Iing (4) �.� ��,� �z8-^�= t{� ,�,,� ��,
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0.ssassed Mobile I ManiCadured Home Garoge (5) t�- _'�� a�."�.`6 �� 4`p'.
.�?_._..��..s._ f �c..
; zj:ir.e �,L't�:�, —
Otherimprovamenb i8) iz "� ��-. tr-F.
Tofal improvemeMS (!!ne I through line � (7)
romi �am. prne � pns �me n (e)
I hereby certify the above is We. correct, �`�°1e oi'�s�Of �� sg� (��. �Y ��
and eomplete.
veify� ac�, - syreare or a„d�mr oa� syr�ea (rr�m. dar, rea.l
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20 _ pay 20 _ Lesser of 60% of the essessed value of the homestead or $45,000
NNwiMStandLg any oMerprovision, Me wm dthe de0uct'arts piovitled in �C G/.7-72 to a moWe hane Naf B b
nof assessetl as real poperty w fo a menutdUwed home tliat is rqf essessetl es red propeRy meY � exceeC . __ _ '
one-haH f21 W Ne essassed velue o/tha rtqWle fame or man�deuured homa.
SignaLUe of Auditw
Date signed (monfh, day, yea�
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