HomeMy WebLinkAboutHomestead_Tackettt CLAIM FOR HOMESTEAD PROPERTY TAX
f CREDIT/STANDARD DEDUCTION
t State Fwm 5473 (R6I403)
- Presaibed by Ue Departrnent of local Govemment Finance
fNSTRUCTIONS: See ravarse side lor filing insfi�ctions.
FORM
HC10
YEAR
I(We) V� /sLJG.LI// Vi certify that on the ist day oi Merch, 20_
I(We) ied as aur dpal place of residence Ne fdlowing descAbed real property tor which a Homestead Property Tac Credit Is hareby daimad:
�I(We) owned !ve buying under contreci ' -�^�
Have a beneficial interest in the entiry that is lieble for Ne property taxes on the property and that owns t#�pryp�[y�`is bu}�g�n r a nvacl.
�
I( Wy4iB on cmVaa. Fee Simple ownets neme
RxwEals oflke whera conVaq Is recorded
Pega
Counry Tovnship T�cing districl (ciry, town, township)
ajcel number y� L d �pibn Is ihe properry In Question:
'�D � OV � � /O ' ❑ Real property ❑ MabOe Home (I.C. 61.1-7)
If any pwtion of the tesidential sW cture m Ihe IaM not exceeding ona (1) ava thal immediately surrounds that aWCture is usad to produce income, desaibe Me use and portlon
of Ne proparcy utllized to pro0uce income.
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.:�:2t. ,,.N:..-, .G.�_���-�% �����a�e_..s'�P.ROPERIY:OWNED�9Y,CL'Al1+lANT:fNOTHER:CbUNTIES�+r$,`�ar�..�.,'„`�".'�'�,.i'k`..la:;�''-'. s"-!Ea�,"_�$::
County Twvnship County � Twvnahip
I hereby certiry the above stetements are We, cortect and complete. Signature oi ueiment
ress (numbei aM sVee4 Gty, atata, ZIP code)
� +`��r�'ti'�"'�`'�`'�'"�'����,��+Sa TRUE:TAX� �. ASSESSEDVALUE,,,�HOMESTEAD.xr'�"��'�NON�RESIDENTIALt�`�
�ASSESSOR U3E�ONLY is °. +, t;� ��' VALUE ;��a �'�AT;100%OF:TTVs Y �VALUE � � f1T r7t "' -*�-�.4 C �
����a"s�-'.'s_��r`srr��srga.�.i��fr-� ..�_� _..�... v -_.w..�.._.�-.f� „�. 4 �-�,VALUE �:.«t�..
land not exceeding 1(one) ecra-immediatety � t`,..,.�ti+� ��?; Ka i ��'^ f
surrounding residential improvements. ( � y��.,�` w,�,.�, ,, �, i�{-;j��„�, ;.":
n.s ' .
Otherland (y� �33 + ..
4' _ F..t;
Tdal land (Ilne 1 plus llne 2) (g)
Dwelling (4) .�,�`,'�''� ��'* at�'�P'``�� ���`,z +k2
Residential improvements orMnually :� � X,<..r 3, �,__�,f <-r ;i
Pssessed Mobile I Manufaclured Home a� �:w_'^*�++'�"^�=-'^ *n> .'.:
Garage (5) '.' x , �,t:�r `�. �:r'��,Fy ,'r .
���- 'rF� �-.;�+-..-'
�
.O�peYimprovements (6) _ - .
Tctal improvements (line 4 through lirre 6) (7� .
Tctal value (Ilne 3 phs line n (g�
I hereby certily the above is We, correci, and � Signaare of nssessor Date signed
complete. .
Verilyin8 adion - Signawre ot Puditw Date signed
20_Pay20_ I
Lesser of 12 Homestead
Valuation w 335,000 $
SigneWre of Puditor