Homestead_Williams (18)CLAIM FOR HOMESTEAD PROPERTY TAX
-" CREDIT/STANDARD DEDUCTION
t � Sfate Farm 5473 (RS / 10-01 �
�� Presaibed Ute
bY Depertmenl N Lacal Govemment Finance
INSTRUCTIONS: See 2verse side /or filing instructions.
FORM
HC10
YEAR
icwe) �/ G�iY�S L— �Q y a� „ma� ts dayof March,20_
i� -r R
I(We) occupied as our prindpal place oi residence the following described real property for which a Hom t ad ro rty Tac:n fedit i� by daimed:
❑ I(We) owned ❑ Are buying under conlract fn�,' �
�Have a benefidal interest in the entily that is liable for the property taxes on ihe property and �hat owns tha propaly�oris F�qu�y under a contrad.
If buying on contract, Fee Simple owners name
ti �UU��V,'.
Recorders office where contracl is remrdetl Recoid numDer Page
�,"'��,''e��F�'�s=`�"�5"r "�°�'�r�-,�.f`�PROPERT;DE§CRIP.TIGN����`y� �'K``ss''�-�,�,.����,�d,....',�
County � 7wmslup Tating daWd t, town, rownship) � �
/�B.10 /✓ fl' %t� .�rQ %y �A / l.c� '
Parcel number Lp� descriDtion Is the properry in question:
Z/� —oo �i'jC' .W N In1 – 7-- I D , Ct7�c'w o�ooaro ❑ r.wwie H«�o p.c. ��. a-�
N any portion of the resi0en9al strucWre w Me land not exceedinp one (1) aae Net immeCiatety surtounds �het swcNre is used to produce Nmme, deavibe Ne une and portbn
of the property uLl'¢eE tn produce ir�mme.
County
Toxnship
I hereby ceAify Ne above statements are We, correct and complete.
uty, atafe, ZIP code)
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