HomeMy WebLinkAboutHomestead_Tichenor� CLAIM FOR HOMESTEAO PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fwm 5473 (RB / 4IX!)
Prescribed by Ue Departmem of Local Gavemment Finance
INSTRUCTIONS: See reverse side Ior filing instrucfions.
� FORM
HC10
YEAR
I M'e) /���/f//X) ��.��La.�(!�J �� ��/ 1C 9i.t F/ � cer6fy Ihat �iflfle � d3Y��rch. 20_
I(We) occupied as our principal place o( residence lhe following described real property (or which a Homestea foperty Tac Credit-is hereby Gaim/ed:
� I(VJe) owned ❑!ve buying under contract J '�--( (//
, Nave a beneficial interest in the entity Nat is liable (or the properry taxes an the pmperty and that owns t p(q�j�to 6g uM��CtontiaU.
II buying on conLad, Fee Simpie owners narne
Remrders office where contraa is
Counry
Parcel
7armship
LegalAescnpUon
Recard number
property ❑ Moblle
H eny portion of Ne residential sWCNre w Ne land nd exceedinp one (1) aae Net immeEiatery wrrounds ihat sWCNre ia used tn produce income,
of the properry utiiz,eE/ b praduce income.
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c�5o , ouu
Page
4C. bf.f-n
Me use and portbn
�"'��,i"�,'--�rc.�waf'Ya`��s`t' K`:zr���Yc-�'s�k�Y�^.Tt�rSTANDARU:DEOUCTION�AL'L'OVJ/WCE�� -;3 " „ s�x�t+: �c"�'-�' �".
' .�. ,.;y g -� �
. . . ... .� �Ei'i iJ._:�':�'AU.^,1=�i1':••��2.��fh�#1Y�:Ci_.n.��'-
20_Pay20_
Lesser of 1/2 Homestead $
v9uaLOn orf35.000
Sipnature o1lwdilw " - Oate signed