HomeMy WebLinkAboutHomestead_Boesc* �'R
g� : � CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
` J State Fwm 5073 (RS / 70-01)
Prescribed by lhe Department of Local Govemment Finance
INSTRUCTIONS: See reverse side /or /iling insWCtions.
9
m YEAR ;
FORM — ,
H�,o o� i
� r a�r �i� JLJ
I(We) � � certify that on the 1sl day of Mamh, 20
I(We) occu as our p n ipal pla residenc he (ollowing described real property for which a Homestead Propert�r�diQsF��y claimed:
❑ I(We) ned Are b ng under contrect
�lave a benefidal interest in the entity that is liable for the property taxes on the property and Ihat owns the �grjy or9s-�iqg�der a q�tr�
����i��.:�.iF''''•3 ¢ �':a.=*"�.{`"'�.��£-==.'�.�..c �'` �"":CONTRACT.:RECORDED�<�,,. ..,'.:;�. . � ��- � *�s . - . _ .
.r
If huying on conVaa, Fee Simple awners name
Rerordefs olfice where wntract is recordetl Record number Page
Toxnship
Legal descnplion
Is U�e
fawn,
�J���������I U I �Realproperry ❑ MobilaHOmo(LG6fJ-7)
If any portion of lhe residenUal sWCture w Ne Wnd not azcaeding one (1 � aae lhat immetliately surrounds that sWCNre is used ta produce income, describe the use and porlion
of the property utilizetl tn produce inmme.
��
y s"�y++�+�x'�'i"�'�'�-� £'� � '*.: �''� �-' TRUE TAJ( ASSESSED.VALUE HOMESTEAD-{ -� s�%'NON RESIDENTIAL` �
�-� �*.,y' °��.�ASSESSOR�US�ONLY i_`��?_4`.a ,�, N ;i�: VAI:UEa .r. . � �AT 100%OFTTV�.., .,.. VALUE.'�� ,�� � � �: VALUE€y,;�.,i'��2�:
Land not exceeding 1(one) acre immediatety 't �� F+.:a�` `��1�,-� �d. ,f
surroundingresidentialimprovemenLS. (�) �-��-;;%�M���•.;;J,;-�;�.-."�+--s��'�%
.�: �a a =
Other land z �` � �'�r''""'�.,�''-,�
( ) }_ .t � . �-,�,�
.a.?
Tctal land (line 7 plus line 2) (g)
�4 N }; �✓ � �c,�rr�+7r+sy � :5
Dwelling �4� { �''F"r �2+��+` '� t5.�yi�ri%.
Residential improvements u' �� ""'�'' � "'�`� °i -'
���-13�z�tti�'`�%� �*'`cr-
Garage (5) ^u�♦� �3ri�'��t r„ * j �.�s��',`
P� T1 � Y.v h. �..��C. -.. r.a� �.
' • .-�-Y�' 1� i
Other improvements (6) `5= �s,. T
h
_ - .�iq�i.�rYj>,-�.',.y.
Tdal improvements (line 4 through line 6) (7)
TUaI value (line 3 plw line n (g�
I hereby certify Ihe above is We, cortecl, and Signamre ofASSessor Date signed
mmplete.
Verifyiig ad"an - Signa Wre of Autlimr Date signed
'r'� s��� T��-'z=`:' �"°`;'?��.,, a�;,'�i:STANDARD'DEUUCTION�ALLOWANCE �- "' '"t`�'' "' �'
�K�,";Y_ti..� =a.�.,..._r4r'--�� �'`"r _ �� ��.t-ik.- a� :o.r=- .�:. -�:�'Y �x_'.''S:�'= -� ,- - -
20_Pay20_
Lesser of 1!2 Homestead
Valualion or 56,000 S
SignaWm ol Auditw Date signM