Homestead_White (7)n.
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARO DEDUCTION
State Form 5473 (RB / {-03)
PrescribeA by Ue Department of Local Govemment Finance
INSTRUCTIONS: See reverse side (or filing instructions.
FORM
HC70
YEAR
�
I(VJe) � certiry that on the tsl day of March, 20_
I(We) occupi s our principal place of described real property for which a Homestead Property Tac Credit is hereby claimed:
❑ I(VJe) ed ❑ Are buying under contract �
iHave a benefidal interest in Ihe entity Mat is liable for the pmperty taxes on the property and that owns the property or is buying under a conVact.
If buying on conVad, Fee Simple ownefs name
Recorders of6ce where caniraa is recorded
Counry
Toxnstdp
7ain9 9rs� (dN.
rarcei n cer tlescription Is ihe
-D�4r Sw 9- a- � i �� �
N eny poAlon W p�e resiAentlel eWCWre w the IanE not exceeding one (7) acre Ihet immetliately wnounds
ot ihe property uGlheA tu praduce i`rcome.
CouNy
Twvnship
I hereby certify the above statemants are We, cortect and compiate.
Address (numbar eM sVeef, ciry, dete, ZIP code)
County
Signature of da"unant
Record number I Page
im� ❑ tilonne Hon,o u.c. s,.,-n
b produce income, describe tha uee and ponbn
Tavnship
.� ��`:aa�.'-���r:.i.�-�5}��Y��rt-."aG;�,�:�t?�f'�',.':ST/1NDARD:�E�UCTION'AL'LOWANCE--.'�>,—_f=3.�1i:_}'' � ��:i.,. „ti�.J»��.>£��,3, 6 .. .,
20_Pay20_ .
Lesser of 1/2 Homestead g
vauenon a E35.000
Signa4ire aflwddw ' � Dale signed