Homestead_Wilzbacher (13)�
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CLAIM FOR HOMESTEAD PROPERTY TAX
s ._ STANDARD / SUPPLEMENTAL DEDUCTION
State Fwm SC73 (R72 / 609)
�° � P2srnbed by the DepaRmem of Loml GavertumN F`anca
INSTRUCTIONS: See reverse side !or filing instrtxtfons
�
FORM YE�
� HC1
OCT 2 2 �utu
..
I e � ' ) as my (our) prindpal
(W ) w
place of residence or am (are) b ng the following described real property for which a esiead Pr��rd�; ��,P '�ereby daimed
under wntracl on the date lhis appfiption is filed, (date olfiling):
e) ovm ❑ Am (are) buying under recorded conVaa
Am (are) entitled to occupy as a tenanastockholder of a cooperative housing corporation
� Have a beneficial interest in the Wst or the right to occupy the properry under ihe terms ot a quaiified pereonal residence Wst
•• • •
Name of da"unant (legel �{a�m) �
y;
Nama of daimaM's s ( I nema)
/
• •-� �
If buyinB ���4 Fee Slmple axnels �me
Remrdefs affce where mnvact is recorded RemN number � Page
..�• • � • •
Counry , TownShiD � Ta�g Q'(tifl: bwn. MwnshiD)
Parcel numher Legal dewiption . Ne pmperty m puestion:
� � Real pmperty ❑ MnuaOy assersed mahile home GC 6f. f-n
tt any poNOn W the residentlal sWCNre or Ihe IarW no1 exceetling w�e (1) aae Nat immediatey surtountls Nat swcNre is used W pro0uca Inwme, desalbe the usa an0 ponion
of �he pmperry utiT¢ed tn pmCUCe inmme. �
a�- zz-�a -.3o3-ao a.a �3 -oa y . -
-.� . .: . .
Caurity Township Counry ' TownsNp
I hereby certify fhe above stetements are We, corted and compiete. sB^�' y�almant
�� %L�°N p` LC�
AtlEress (�u�a9�.5tree; qly, S(eie, and��e(1"i/"G��� (� � �GN�—� �/ �V / 76 /
� � /jii
•• �
� • � � • �
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Land not e:ceedin 1 one acre Immediate � h ,�^��I°• �`��`'' �
9 ( ) �Y � ��,'`����+{":�i�'��t �-f.K��'2�..�t'
surtountlin re5ldential im rovemen6. ( � r�{
Other land � � (2) � �',�,*,`�`�.,t.�E;�;1p�'�t,x,�t
ToUI land (line 1 plus line � (3)
Dweliing (4) `i�„3''x� 3n`y3r �t� a`. .mF
ResldentiallmpmvemenborMnually ''*`-' s����:�F�����*
�.�, x .?€--:
AsesseC Mobiie I Manu(acwred Home Garage (5) ' =�'��'�`4.���.i��a �'v�~`'''�^�
E'ss,.r}3' b. .�.t�:r. ,f'_�iF`sY,'�.
'x^--__Y'14a-.., '+e'=4°-"�,E£
Other Impmvem¢rtls (6) �:y�y�„i;�
' _ .. F+.�. 4F:
7ota1 Impmvemenis (line / througAline � (7)
rota� vame (nne 9Wia une � (a)
I hereby certify the above is true, cortect, � Sgnature at Assasmr Da:e signed (monih, tlay, yea�
and complete.
Vailying a�on - Sig(uwre ofluitlitor Date signed (rtronN, Eay, yea�
�.-� � � � �
20 pay 20 Lesser of 60% of 1he assessed value of the homestead or $45,000 '
Nolwi(hslaMUg anY �er P�nsion, Ne sum olthe tletlurlmns proinded in IC Ef.7.12 fo a mobde Ipme Nef /s $
raf essessed as ieal proparty w to a menufaUUred hwne Nef a rof assessed es reel properry may rwt erceed _
one-heH (f2f W Ne assessetl refue of fhe mobde fwme w manNaflurtM hon�e.
SlgraWre ot PuEitor Date signe0 (mmN, Eay, yoa�