HomeMy WebLinkAboutHomestead_HokeCLAIM FOR HOMESTEAD PROPERTY TAX
" " CREDIT/STANDARD DEDUCTION
t.r � S�2te Form 5473 (RS / 10-01 �
Prescribed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side !or filing instructions.
_ FORM _ YEAR
HC10
11 � .�.�/ �-- ' `� _
_J
I(We) --- `\ . �°c' l�� � XrL� �� �� 1� ce�ai on the 1st d of Mar 20�
I(We) occupied as our prin ' I place of residence the following describ real prop forwhich a Homeste�j Property-Tac�Cred�s�hereby�^d—a� �ed:
� (We) owned ❑ fve buying under contract U . . . ��_ ::?C: � 1
, Have a benefidal inlerest in the entity that is liable for the property taxes on the properry and that owns lhe property or is buying under a contrad.
If buying on conVacl, Fee Simple owirers name
contrad
County
Township
L%� � ri.i���0� � "L�7 ���0` (O�
N any poAion a/ Ne residenllal strucWre w Ne IanG not excaeding one
of tha property uUlized tn produce income.
County
I hereby certify Ihe abova statements are We, corted and complete.
�
Net imrt
Record number
tlisViU (dly.town,
Page
^ Is Ihe pmperty in quesUon:
J ❑ Real propery ❑ MoWle Momo (I.C. 61.1-n .
sunounds thet sWCWre is used b D��� �nmme. Aesaibe Me use and portion
l
Tavnship
20_Pay20_
Lesser of 12 Homestead
Valuafion or $6,000
Signature
S
Date sig ed
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