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t CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� State Fortn 5473 (R811-03) , �
PreStribed by the Departmenl of Local Govemment Finance � � �
INSTRUCTIONS: See revcrsc sidc Ior Iiling lnsfn�r.(ions.
FORM
HC10
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YEAR
� M�e) �' �l-Vi cert�fy ihat on the 1st day of March, 20_
I e occu ied as our ri � '
(W ) p p 'pal place of residence the (ollowing descnbed real perty for which a Homestead Property T�c Credit is hereby daimed:
: ,,i_ .
❑ I(We) owned fve buying under wnt2ct v.' ' ��y 1�;, .
� Have a benefidal interest in Ne enti �hat Is liable (or the ro e taxes on the ro e and tliat owns Uie� ro e,J or� s b n under a conVaU.
tY P P NY P P hY P P rtY �M 9
I( buying on conirad, Fee Simple owners name
corrtacl is recorde0
Tamship
Legal
H any ponbn ol itie residentlel sWCWre w tha land not
of ihe property uti¢ed tn produce i�ome.
County
Toxnship
one (7) arre that
I hereby certify the above statements are W e, wved and complete.
shee(, ciry, state,
Record number � Page
Tating
/.�I�a P�M in Question: �
,��Y/ ❑ Real property ❑ Mobile Homo (/.G. 6f. f-7) .
sunounds that swcture is used b produce income. desaibe the use and portbn
Coun�y
Twvnship
20 _ Pay 20 _
Lesserof 1/2 Homestead
veluauon w 535.000
/uWnw
$
= a.� -