Homestead_Wilkison (3)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
SIeU Fam 5473 (R6 / 4-03)
Piwmbed by the Departnmt d Loul Govemmerrt fuia�e
� INSTRUCTIONS: See iewraa aldo b f�np in�6urbons.
FORM
HC10
H � ''�
�
YEAR
� M'e) \ `� '� 7- v/ eiti � ihat on 1h��7s�t�day of March, 20_
I(We) occupied as our prin pal place of residence the (oflowing describ real property for which a Homeste�-ayd �P�roperty T�c Credit is hereby daimed:
❑ I(We) owned ❑ Are buying under wnt2ct l/'�a� ��
� Have a benefidal interest in the entity ihat is liable for the properry taxes on the property and that a'vns the p7opertyTor is.bli}nng under a conVad.
I( buying on conVacl, Fee Simple owners name
RecoNers ofice where conVacl is remrded
Parcel�e�e� _
W
Toxnship
Lagal
I/ any portion of Ne resitlential sW dure w the land not e:ceeding one (1
of ihe properry uti¢etl tn proCuce inmme.
Coun�y
I hereby certiry the above statements are W e, wrtect and complele.
and sheef, ciry, s!a(e, ZIP code)
7sing a¢trict (dry, mwn,
I '� / � � /s Ne pro�
lill (
Nat immeCiatey wrrounds that
Coun�y
of Uaimant
Record number
Page
irty ❑ Mobile Homo (/.G. 61.1-�
b protluce income. Cescribe 1he use and portbn
Twvnship
�f ' �` ���� ^E"����"^��` t� y ' TRUETAX `� ASSESSEO�VALUE � HOlAESTEADiF � N=RESIDENTIAL�
���fAS3ESSORiUSE ONLY���9�J�� � �ta.t�; -e � ' � ��' ' `,`,VALUEr ' �^�i,
� _� � �y&1���g�.�� y ,�: �VALUE�t AT700%OF�TN � VALUEf ��fh�?-' u..��
„�... _. n._�``. �; _ � �t, ,>
Land not exceeding 1(one) acre immediatety �,''"�` ��''v`P °� '�'="�} ��
surrounding residentlal improvements. �� ) �� �"'�N �`���� � �.-r�� � '
` r_. t n,_ '5.�.'i`
Otherland (2) fifP?��'� .
3-�' aa5
Tdal land (line 1 plus line 2) � (g�
�. .... U' l 1 -_��c .t'r.' �
.�t'¢�j iIL-r'�' fis�d:.}�ie�.F sr:.i
S
I DWE��II19 (4� �7'-�f�����IS%a.���N ��
�Residentiel improvements orMnuaOy �p�.
Aaseased AAObib / Manufac�red Hane Gara e ��:��i.� ��''"''.s'F�. �� �"�%z'i
9 (5) ��i���..�:��������,�
a�s' �_ � .. >
Otherimprovements (6) � ����
;e
Tdal improvements (line 4 through line 6) ��)
�al vatue (line 3 plts line � (g)
I hereby certify �he above is We, Corred, and Signalure of Asseswr Date signed
complete. .
Verifyi�g action - SignaNre of fwditor Date signed
20 _ Pay 20 _
Lesserof 1i2 Homestead
vaueuon a f35.000
S
Date s�n�d / /� � �r
/ � J