HomeMy WebLinkAboutHomestead_Lamey (19)" CLAIM FOR HOMESTEAD PROPERTY TAX
� ._� � STANDARD / SUPPLEMENTAL DEDUCTION
State Form 5473 (R12 / 6-09)
�� = Presfsibed by Ihe Department of Loml Govemment Frence
ri 4 : s�
1 ?t!�
�I 'ij -';, i ��
���
�
INSTRUCTIONS: See reverse side for filing ins(mctlons. -
�..
. �
I(We) ceAirytna-tT �we) o�PN� es my (our) prindpal
place of residence or am (are) bCr g the following described real property for which a Homestead Property 7ax Standard Deduction is hereby daimed
under conVaG on Ihe date this applintion is filed, (date oflling):
� I(We) own ❑ Am (are) buying under recorded contract
❑ Am (are) entitled to occupy as a tenanastockholder of a cooperative housing corporation
� Have a benefidal interest in the Wst or the right to occupy ihe property under Ihe [ertns of a qualified personal residence Wst
•- , �
• ••� �
116uy+ng om m�trad, Fee Simple ownefs wme
Remrders ofire where mntraG is remNed Remrd number Page
""�. . � • �
��n. � Trnmship T' 4' -ct (rity, tawn, township)
Parcel number Legal descriplim Is e perty in quesfion:
�' 3•• b � (� .� eal PmPenY ❑ MnuaAy assessed moh'le hame (/C G1.1-7)
It any poM1ion ot Ihe residential swcW re or Ne Ia�W rnt exceeding me (1) aoe Ihat imrtiediatnJy surtau�WS that sWCG�ra is used to proAUce imm�e. desrlibe the use and portion
aW
o� me woP�m wraea m woa�ce ixome.
•�• • �: � �
Counry \ Township/ � Caunry � Township
S� �
SI9naNre of 'mant � '
I hereby certify the above statements are we, correcl and complele. � _ y` �_
w tti�^ti
AO ess (rvimber and t, ary, sfefe, antl LPcode)
oa
� . �� . �
•• • �� ..
Land not exceetling 1(one) acre immediatety � � 3• ti <�"���� �^"`.�`� -q3cs';
sunoundin residentialim rovements. � 1 �'x'.:--.'.�"s�'�'.,•.-t.,-�. .N+t�=^m.0
Otherland (2) �tiR ' �^�-�
Total land (line 1 plus line � (3)
9 ( ) �z."�,--%v �i�5a dt .�` ";:
Residential improvemen5 or Annualty ����� 4 � 1����`� f�y` ��
Assessad Mobile 1 Manutactured Home Gara e - 3"''x F���A ��'r ��
9 is) -:.3•`.� f.�wv-i�,-�'� K %�r....:
.�'1 ,; :r ..
Otherimprovements (6) ; � � ��' S°.[r�.
Total Improvemenis (llne / Nmugh Ilne � (7)
Total value (ftne 3 pl�s line � (8)
I hereby certify ihe above is true, cortect, 5�"av� °f �e� Date signed (monfi, day, year)
and complete.
Vailying acam - Signan�re ofluiditw Date signed (rtronN, dey, year)
�..� � � • •
20 _ pay 20 Lesser of 60% ot the assessed value of the homestead or $45,000
Nofwi(hslaMinganyotherproWSirn,NesumWthedeductiwuWONCedinIC61.1-f2toamobilefamefhatic g
rot essessed as real property a 10 e menufaUUred home fhat a rot esseued as real property may rwt exceed
one-hall (1R) W Me assassetl ve/ue W the mob�e fama or manutdcfuietl home.
Signawre otNMi Date signed (rtmntA, day, yea�
-a�