Homestead_Millera
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�=' CLAIM FOR HOMESTEAD PROPERTY TAX
s ��- STANDARDISUPPLEMENTALDEDUCTION
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LVSTRUCTIONS: See reverse side for lding instmctions.
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�NiB� � ��"�� ceNtyNall(we)o vP�'ay(�
place of resitlence or am (are) - g fMwnng Eesaibed real property fw whirh a Homesteaa Property Tax �a�p.petl��qyy� i
vMprconVactwlheEatethis pGmlionisfJed. (daleWNirg): SOfJ l•Vl.
l� I(VJe) wm ❑ Am (are) buymg vnder recorEetl mntrocl
� Artl (af¢) ¢nti�ed lo ocNpy d5 d �enan451pCkhOlEel of a c000e�alive IIWSing fAryOfdGOn
� Have a bene(tial in;eresl in Ne hust or I�e ngM �o occupy Ne pmperty unEer Ne �ertns of a qualiGetl personal resi0ence wst
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m me nwenr �u:m m o�m�a �o„e. �/ �O ' Cf �/L
a�-z3-��- 300-000.0��-0 �.y
��Y TonizND Cwnry
I hereGy certity Ne a0ove sUtements are we, wrteG and comde�e. \, Sg �urt tl�vwn
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t lonel aae unmeElateh I(�)
tial Imorwemenss.
ON�r IanE
Toivi IanE (One 1 plus line 1)
ResidentlalimpmvemenhorAnnua�y ������9
AssessedNObOe/Mamrtanuretlllome Wrage
Other'unProvemenb
Tofal Mprovementa (/ine � Nnug� INe 6j
To�al value (Ilna J phrs Ilne n
I hereby certity Ihe above is we, cortecf,
anE comple�e.
V }igxvm-SgnawreWPUEibr
(3)
(5)
20 _ pay 20 _ Lesser o( 60% of Ihe assessed value of Ihe �omesteaE or 515.000
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