Homestead_Wheeler Childrens Irrev Trust�, R�� . CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
`� � State Form 5473 (R4 / &00)
INSTRUCTIONS: See reverse side (or filing insWcfions.
�;Y��i�li�il;��
F� O E 2O '' R
HC10 /�
n `�i
GIBSON COUN-Y AUDI70R
I(We) certify that'on the tst day of March, 20_
I(We) occupied as our principai pla of residence the following descnbed real property (or whirh a Hamestead Property Tac Cred'R is hereby daimed:
� I(We) owned ❑ Are buyin9 under contrad
�-lave a beneficial interest in Ne entiry that is liable tor the property taxes on the property and that owns the property or is buying under a contrad.
II buyir�j on conVact Fee S'unple awnefs name
Counry
Tamship
tlisirict (cify, fown.
RecoM number
Parcel number � Legal tlesttiption � �
���- oa«v�b �
If any pMion oLNe residenUal sW c[ure or the Wnd iwt exceeding one (1) ave that immediatey surtounds that sWGure is used to p`otluce
o( the property utilizetl w protluce income. � � -
Page � _
and pwdm