HomeMy WebLinkAboutHomestead_Kite (3); CLAIM FOR HOMESTEAD PROPERTY iAX
CREDIT/STANDARD DEDUCTION
t � Staie Form Sa73 (R6 / 4-03)
Prescnbed by lhe Departmenl of Local Govemment Finance
INSTRUCTIONS: See revcrsc side !or /ilinq ins6uclinns.
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FORM YEAR
HC10
Ix .TS�:. � � -,. a r:�,-•: - -., �°' . : CERTIFICATONSTATEMENT:�. . _.. . ;'. r..,.�,.j�...�:..�—r1 .�
��� 1(We) �� • ) � certify lhat on the 1st dCaCVpof Mparch, 2�0��
I I(We) occupied as our principal place of resid�the (ollowing described real property (or which a Homestead Property Tac Cr6d�W hbe� �6hMld:
❑ I(We) owned ❑ Are buying under wntrect ��/
� Have a benefidal interest in the entity that is liable (or the pmperty taxes on Ihe property and Nat owns lhe property or is bu '�i�NIRJ¢rr5�8ffJ�ict.
If buying on contraG, Fee Simple owner's name
Recorders olfice where contract is recorded
Counry
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Record number Page
_:_, „_.. . _ ._,�-.. ._ :.�s_ '-.==BROBERTYDESCRIPTION"�T.� -. �-`,:. , • : -�-, � . ...r,.:�, � ,— -
To.vnship Tacing district (ury, town, township)
Le al s" i n Is the property in question:
4�� � � �� ❑ Real pro0erty ❑ M1tobila Homo (I.C. 67. f-7)
ddenlial sVUCNre w the land not exceeding one (1) acre t�at immediatety surtounds ihat sWCture is used to produce incame. desaiba Ue use and portion
to produca income. ', I ^ ��
tJ�
Tawnship
I hereby certify Ihe above slatements are W e, wnect and comp�ete.
Add ss y�er and re , ciry, state, jJP co�[e) � ��
k-� -'r.n x �ss --: - - _ ,. , . . . .. _ _ , .
�x�t�yt°'ASSESSOR��USEONLY� ;TRUE�TAX � ASSESSEDVALUE HOMESTEAD'-� NON-RESIDENTIAC,; �
+� F� h r �r � ,_ -._: . � .:. - VALUE � - �.:�. : AT 100°/a:OF:TTV :?" " VALUE �:r' . '� '_'VALUEi �
x..� :��.s;'�.
Land not exceeding 1(one) acre immediatety ;r 'x - -�"i'�
surroundmgresidentialimprovements. (�) .-� ?-' � .�
Other land �p) �- .. �
Tdal land (line 7 plus line 2) (g)
Dwelling (4) �.; :'� _ . j.. . _
Residenliel improvements orMnually � � __ x
Assassed Mobile / ManufacNred Home Garege �5� _ �
Other improvemenis (6) -
Tdal improvements (line 4 through line 6) (7� � -
Tcial value (line 3 ph5line � (g�
I hereby certify Ihe above is We, covect, and Signamre ofAssessor oate signed
complete.
Vprilying actbn - SignaWre of Fwditor Date signetl
20_Pay20_
Lesser of 1!2 Homes:ead
ValuaUOn w $35.000
oeoucnoN
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SynaWre of Audaw i 1 I �t = i/ � Date
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