Homestead_Warner�, CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
� Si.ite Farm Sd73 (R6 / 4-03)
Prescnbed by Ihe Department of Local Govemmenl Finance
See reverse-side lor filmq insfmc(ions.
�a� FORM YEAR
HC10 �
� �' � � �
I(We) I r ° certify that on the 7st day of March, 20
I(We) occupied as our p cipal place oi residence the following described real property for which a Homestead Property T�i Cred1it i�s he�r/e`tiy� d'a/imed:
� I(We) owned ❑ Are buying under coniract ��"�' `�'%^�� �'"`"'C`''�f
G1°_S�:d CGCI. � Y�.C"��(TC:, i
Have a benefidal interest in the entity that is liable for the property taxes on the property and ihat owns the property or is buying under a wntraU.
I( buying on contrad. Fee Simde ownefs name
Remrdefs ofice where conVatt is rewrCed
Tamship
La9ai
H any poNOn ol lhe residentlal sW cWre w the land not axcee�ing one (1 J arre
ot Ihe property Wlized to praduce inmme.
Tming datrict
the property in question:
Record number � Page
❑ Mobile Homo (/.C. 61.
that struGUre is used to proEuca income, Eesaibe the use and portlon