HomeMy WebLinkAboutHomestead_Myers (3)CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
t .� State Fam 5473 (R5 / 10-01)
�•� Prescribed by Iha DepaAment N Local Gavemment Finance
INSTRUCTIONS: See reverse side lor (Irng instructions.
FORM
HC10
YEAR
1(We) - �� certify�a�on`�hV1�IpB�ofMarch,20_
I(We upied as our principal place oi residence the following described real pmp for which a Homestead Property T�c Credit is hereb daimed:
/
Lj}' I(VJe) owned ❑!ve buying under contract �
� Have a benefidal interest in the entity Nat is liable for fhe pmperty taxes on the property and that _ s��r�opertyjor.is buying p�Wr a conVad.
I( buying m conLaq. Fee Simple ownefs name
Counry
H any
of ihe
County
ol
whera mnVact is remrdetl
Tawnship
9_ � I �..nl �/ � �./`L.(/ / /
strudure w the land nd mcceedinp one (1) ave tliat
�ce irrcort�e.
Twrnship
I hereby cerfiy the above statemenLs are We, corred and complete.
Address (number arM street, dty, afafe, ZIP code)
Record number � Page
Taing disVict
ihe P�DertY in
�'� L�vaea� oroaanv u naowie H«no t�.c. a�.�-7)
wrtounds ihat sWCWre is used W produce income. tlesrribe ihe use and poNon
County
)%/L�
/" � � 5
20 y� Pay 20 �
Leuer of 1/2 Homestead
Valua6on or $6,000
signed
� � � �