HomeMy WebLinkAboutHomestead_DyerCLAIM FOR HOMESTEAD PROPERNTAX
CREDIT/STANDARD DEDUCTION
� State Fortn 5673 (R6 / 4-03)
Prescribed by Ne Department of Local Govemment Finance
INSTRUCTIONS: See reverse side for filing insfixtions.
FORM ����, �YEAR _,
HC10 u
I(We) Y certify that on the t�s�t d�a� o( March, 20
I(We) occupied as our principal I of reside e lhe following described real property for which a Homestea��qpe� Tac aletllt is hereby daimed:
❑ I(V✓e) owned ❑ fve buying under contract
' Have a beneficial interest in the entity that is liable for ihe property taxes on the property and that owns the pro�"perty_oras-bu�ng under a wntract.
1! buying on conVad, Fee Simple ownefs name
Remrdars olfice whera contraIX is recorded
County
_v��-� a�-c-v� i
If any ponim of Ne residenUal aWcture a the
of the p�ro�p 'ulilatd to produce inmme.
�Y/Iin.D�
one�t)aae
Record number � Page
Tacing district (ciry, town, township)
N Is the O�oyerty in question
❑ Real properry ❑ Mobile Homo (I.C. 61.1-7)
surtounds that swCUre is used W pratluca income, dewibe tha use and poNon
20_Pay20_
Lesserof 1r2 Homestead
vauauon w 535.000
SgnaWre o(lwddor
E