Homestead_Hacker�} CIAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (RB / 4QiJ
Prescribed by lhe Department of Local Govemment Finance
Property;Tac Cr i.is, ere. y efi —
r �
1(We) owned ❑ Are 'ng under wnUacf �""� Audi[or
, Have a benefidal interest in the en6ty that is liable for the property taxes on the pmperty and that owns the � i� �' � der-�� "EaiSmcC`ounty
II buying on cont2ct, Fee Simple owners name
Recordefs office whera wnVad is recorded
County
Township
I Is the propery in question:
1 � ��I DroD
i n
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Page
Mobile Homo (I.C. 6/.7-n
If eny portion o( Ne residenllal aLucture or the land nDt exceedinp ona (7 � a�re Ihet immedialey surrounds Nat swGUre is usetl to protluce income, tleuribe Me use and portion
of the property utifized to produce income.
=K'a"� <.:'����a�%'.�.-�aPROP.ERT.Y.OWNED:BY;CL''AINWNT-IN;OTHER`COUNTIES,if`�.,��.-�`'�.������_.tS-5`�s?l�„��`a-'�"
County Toxnship County Twvnship _
1 hereby certify ihe above statements are We, corred and complete. Signatqre ot tlaimam �
C�� 6 Cf�t _i
Ad ssLnulberandske�tOXate,ZlPCOde) /'� . "Iti�l ��V / / LO / V I
� �J S �����ce
20 _ Pay 20 _
Lesser ot 1 Y2 Homestead
VauaLOn a
Signature of Auditw ' /�� � A / 1 / / / � I f� I Date�vp_�d � � -�
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