HomeMy WebLinkAboutHomestead_Barton (2)' �'"'" CLAIM FOR HOMESTEAD PROPERTYTAX
V, � ._ _ � STANDARD / SUPPLEMENTAL DEDUCTION
State Fortn 5473 (R72 / 6-09)
�O ,�„ � PresuiCeC by the Department of Local Govemment Frmnce
INSTRUCTIONS: See reverse side for hling inst/ucfions.
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FEB 1 8 2010
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I M�e) certAjl�aRm�Q6�h�7c�A 71�ImITQDii Prindpal
place of resi am ( ) buying the follovn described real property tor which a Homestead Property Tax Standard Deduction is hereby daimed
under conVact on the date �his appfiration is filed. (tlate o/filing):
❑ I(V✓e) mvn ❑ Am (are) buying under recorded contract
❑ Am (are) enGtled to occupy as a fenanFStockholder of a cooperative housing corporation
� Have a beneFlCial interesi in ihe Wst or the right to occupy the propetly under Ne tertns of a quali(ed personal residence Wst
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Name da' t (legal name)
Soda ' im6r1
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It buying om m�VacY, Fee Simple owneh name
RemrEers oKrs where mnvaq is recorde0 Remrd number Page
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�nry Township Tating d'atria (rily, rown, town.rhiP)
/� P=rce numb r Legal d 'ptlm Is l�e propeM � question:
a� ❑ Reai wo7enY ❑ Annuatly assessetl rtmbile home (IC bt. i-7)
It any portion of Ne rnsitlenlial slrut�re w Ne land not esceed"ug rne ) afYe Ihat immediately SUrtou�Ms Ihat sWCWre is usetl to protltxr imm�e. EeSrfibe �Ile use and portlOn
of Ne pmpe�ty utiT¢ed tn pmduce inmme.
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Caunry Trnmship Caunry TownsNp
I hereby certify the above statements are we, corted and complete. Signawra o d' i � A� �
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AECress (num0er antl stree( ury, stata, entl ZIP cade)
s3� /.v ,i/o,s 'i/co�a7 � 7p
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. lane not eiceeding t(one) acre immediatey �:;� �''" `-4-;r" -'-+ r'-" -:e�:�=
surtoundin residential im rovements. ��) �kf%s ��^`'`'tx=��,�' �.�'ss �
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ONer land (2) }`e��' � � �����
7otal land (line 1 plus line Z) (3)
ResidentlallmpravementsorMnuaily �����8 �4) -��'�rr����Y ���nX�`�
} '. rf zf :'E �`'k3� ..cf. .�+
0.ssessetl Mobile I Manu(actured Home `� F�'+;�t�y�t ��;a; �
Garage (5) �a��- s L,r � r � . �:n
'"'1 ._�i i" �.•�"r--.
-n'"�..sy.i:+`'i�'��:u; �
Otherimprovementa (6) �.c;!4._. -{�y,;:_ .
Total ImOrovements (Ilne 4 through Itne 6] (7)
Totai value (line7 pflc I(ne n (8)
I herehy certify the above is true, [ortect, SigraWre of0.ssessor Date slgnatl (month, tlay, year)
and complete.
Velif�ng aclion - Sigriawre ol Nid�mr Date signed (monN. daY. 3*a�
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20 _ pay 20 _ Lesser o( 60% o( Ne assessed value of the homestead or $45,000
NolwifhsfaMing any olherpm�ivon. Ne sum olthe dedutlions provtled in IC G7. f-77 m a mobJa fame Na( is S
not assessed as real property or m a menufaaurad hane fhat is ral essessed as reel propeny mey mt erceed
one�hell (72) o/ the assessed rdlue o/ fhe mob0e � e w manutaCU2d home.
SignaWre of Audrtnr n Da�e signeC (month, Eay, year)
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