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� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
S � State Form 5473 (R4 / &00)
INSTRUCTIONS: See reverse side for
l� Q SS- 1
� (yye) ""'�..�. �!-+ V��rti�j
I(VJe) occupied as our principal p�ace of residence e o cnbed�real property for which a Homeslead
❑ I(We) owned ❑ Are buying under contrad
.iave a benefidal interest in the entity that is liable for the property taxes on the property and Nat owns theA
If buy"ug on conVac4 Fee Simpie owneYS name
Recordets office where contract is recoNed
Tavnship
Legaldesaip�on
If arry poriion ol ihe residential sW Gure w ihe land
of Ue property utiiaetl to produce income.
rown,
FORM Y
Hc,o (� -p 6 �
��Ciepjt i�qgr,gby daimed:
if Il U I
�r is b"yin � nder a ontrac3.
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1 COI�!1T1' AUDITOR I
s.s..�,�:��s�.�
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number , Page "
one (1) aae thal immediatey surtounds that siruuure is used to produce iMOme, describe tne use ana portion