HomeMy WebLinkAboutHomestead_Bryce" CLAIM FOR HOMESTEAD PROPERTY TAX
i._ STANDARD/SUPPLEMENTALDEDUCTION
Slate Fortn 5473 (R72 / 6-09)
�' � PrescAbed by the Depanment of Lacal Gwemment France
INSTRUCTIONS: See ieverse side for filing instnictions.
� FORM
LI _� ,
� � HC70
• -
I(We) certiry that I(we) ocwpied as my (our) prindpal
place of residen r am (are) buying the following described real prope fw which a Homestead Pmperty Ta��n is hereby daimed
under conVact on e date this appliqUon is filed, (date o/filing):
aIBeON COUNTY AUDITpR
�I (We) own ❑ Am (are) buying under remrded conUact
Am (are) entiUed to occupy as a tenanFStockholder of a cooperative housing corporation
� Have a benefidal interest in Ne Wst or the righ[ [o occupy the property under the terms of a qualified personai residence wst
.• . •
Name a'unam(Iegalname)
�
sodai s�,my or aa�
�
Sofial Seariry numbu of qalmant'
0/ nYS spouse (Wst frve d'yNS)
(/
• ••� �
1( buying om m�trac� Fce Simple ownefs rame
Remrders oRre where mntract is recoreeE Record num6u Page
..�. _ � . �
County Township Taring tlisUip (ciry, fown, fownship)
Paicel numher Legal descriplirn Is Ne pioperty in questiwr.
❑� P�DP�Y ❑ AnnuaOy assesseA mo6ile hame (IC 61.7-�
�If any por�im of the revdential strucWre or Ihe Ia�W not exreedirg me (1) ave �hat immadiatety surtountls Ihat swcWre is useC [o produce irroome, desalbe ihe use anE portion
of Ne property utif¢ed to produce inmme.
I al�-�a-p�-�too-�I ��d-7-6a�
-.. . , : . .
County Township Caunry Township
I hereby cenify the above statements are We, cortect and complete. S' a' �
�;
Eress (wmber and sheet, ary, ate.e, and LPcode) �
� C-. D. l. �o �l'1 7�0�0
.- .
. . •� . �
�� ..
Land not e:ceeding 1(one) acre immediatety r�„���,T" '�`^`^'r',.k� �I�:?R�;:?:
surtoundin residentialim rovements. (�) .,,,,.��s:�j?.� �.:.��:�.. +,��.�s�:
�:�,
Other land (2) '':� v.�+�=`'t�,j�:�i?'s�G
Total land (line 7 plus line � (3)
�'7r; �.Se, �g v � � �.'� d -'.ti "`:.
Residential improvements or Mnualty �Iiing (4) .;. �� ��� �r� �_��
AtseSSed Mohile I Manufactured Home Ga2ge (5) � w�*�����'� ,��,� ,.��eN�,-'�y� �-`��
Other imOrovements (6) ��`= �'• �s�' :` �•:`.�` "��
i4,x..•�:-^"�tA• ✓%:'.:�
n3:. .:�..�.,Ef.
Total Improvements (llne I thmugh line � (7)
Total value (lina 9 phs 1/ne 7) (B)
I hereby eertify fhe above is true, cortect, Signahire of Assessar Date signetl (month, tlay, }rea�
and complete.
Vaifying aqion - SignaNre ot Auditw Date signed (monfh, tlay, yee�
� . - � � � • �
20 pay 20 Lesser of 60°� of Ne assessetl value of the homestead or $45,000
NoM1�VACfarM4g any otherprosision, Ne sum af Na detlurlions prmTOed in IC &7.1-f2 to a rtqbde fpme Ihaf is $
rwt assessed as ieel properry w fo a menNac(ured hwne that k not assessed es real pmperty may rof esraed
e-hall (12J o/ Ne assessetl velue f Ne mobtie home or manufarturetl home.
5' na f Auditw Date signed (monN, tlay, yea�