HomeMy WebLinkAboutHomestead_KimbroughCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
t � Slate Fwm 5473 (RS / 10-01)
��u Prescribed by Ihe Deparhnent of Lacal Govemment Finance
INSTRUC710NS: See reverse side for (ling instr�ctions.
FORM
T HC10
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YEAR
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I(We) �/ /��M I IINIiLJ Gl.�'� cefi�fy that on the'tst�sy of March, 20
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I(We) occupied a our principal place of residence ihe following scribed real property for which a Homesfead`PropertyfTac Gedit is hereby daimed:
- e18SON CO...;-: . � v.�•
❑ I(We) owned ❑ Are buying under contracl �'%�"C". %
�Have a benefidal interesl in ihe entity that is liable for the property taxes on the property and thal owns fhe property or is buying under a contraG.
I( buy4ig on coniraG. Fee Simpie ownefs name
whera wnVact is remrded
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Tamship
struch�re w Me land not escceding one (tj.
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�t�o.�,.�
Tating distritt
RecoM number
❑ Mobile Homo
Page
immediatey wrtounds that sWGure Is used to protluce inmma, describa Ne usa and pwtbn
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�`�3..-��t�;��4V'��d"'i�'*�""+r���� FROP.ERTY,OWNED BY;CL'AIAAANT IN';OTHER'COUNTIES'�t`�,o���.'�—��'�c�=�'w,"��F'�,�'�
County Tawnship County Tavnship
I hereby certify the above statements are We, corred and complele. Siqnawre otciaimant
�reu (number eM street, dry, sfate, ZlPCede)
20 _ Pay 20 _
Lesser of 1!2 Homestead
Valuatlon or $6,000
ii- 03