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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDR/STANDARD DEDUCTION
sr� F«m sar3 �t� i so�
Prasrn'6ed by ihe Deper6nant of Laol Govertur�eM Finante
INSTRUCT7QNS: See reverse side ta filing instrudions,,y�
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I(We) / / X�Gt./t�`�� vi certify that on the t st day W Mamh, 20_
1(We) oaupied as aa prmdpal p o( resid ihe folbwirg desaibed real property for which a Homestead Property Tmc Credit is hareby daimed:
�rn � M�e) owned ❑ Are buying under mntrsd
riave a benefidal interest m the entity that is liade for Me property ta�ces on the properly and fhat ams fhe property w is buying under a contracL
tt buyrq om m�traq. Fee Sirt�le ownels rmme
wn,e�e wmea U �ec«ded
Ca�mry
Pa� munbm
x / -oi ol -/d "i7Cl GY- 00�4�$.pf
H arry porEOn ol iha rmideNial ctruchee a fhe
d ihe poperty ulifimtl ro prothM:e mmme.
dewipGm
Ta�q7 disUi�t (cd}; town. for�ttldp)
Is �he
exceeding ore (1) aae Mat unmadwtely airtaunds U�at
Reel
Remrd number I Pega
� �J Mobile Fiome (I.C. 61. f-�
pmdice'vimrtie. daxri6e Ne uae aM portion
����;"a.''�.,��""'��^.�k'�""�n1�'r�a.i/,R.3't���yi--i. �'`a�E,�'"�TRUETAX`�etice ASSESSmVACUE ` HOMESTEAD l ��,s�NON-RESIDENTINL���'ic�'`i
�ar�a�wY1��AS3�ESSORUSE�.§WlLnvr,.:.. �?+�� .,�'-,VALUE`��%N.Y,f,�ATS100!LOFTTVx{�`vt''VAL'UEa'��2;iq.,�'�4`.`r�`VAL'UE�2s �5�+.�
�.
Land not exceedirg 7(one) aae irrmediately �;�h ti�e`t� ..,` �q.y ��`� a i��v„
wrroundirg residential improvemenh. (� � {,f}�^,�. � �"�4' �},"rt�,.,�;j � �`� :
� a s. �a�t ��
Qtlierland (2) 'j���,i-'�j-�.,�."��" �.`8:
"R{Y:34i�M1�I`�� .l',��-`�� '
Tcfal WfM (I'o�e 1 plus 6re � �g)
��1 � `^\�i`�f� Y�� } �r
Resdentiel'vnprvvementsarMnualy DwelGrg (4) ��,�r.���:r�,��,`�' ��"
"a°x'..:� .tiSe4;�"'
a�a n+o�ae i � r�» ��Q �5� ,uy� �4�"`�'�}h�;,��f�i:`��,�t
��.�i�fi�����.M�.S:�. ,?iaiEs.. ��t?�
���L �J �� �j'� _
zD �f ���
Other impovertients (6) �:�5.fi'✓,��;;
�..t�i-��:. �.rv,w.e.
Tdal'vnprovemerrts (fine 4 through 6ne 6) (7)
TUaI value (I'vre 3 pGs Gne n (g)
I Aereby oeAify the above is W e. corred, and Sig�wra oi Assegsor Da1e cigned
complete.
VHIhIf10 841�Of1- $IOItBhRB Oi AlId11R Q2IB 61AfI0d
PLdiiv
aoiL aay z�a
Lesser d 72 Homestead
Valuatim w f35,000
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r-. uc �c, pa
Date signed