Homestead_Whetstone (4)�.
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
} CREDIT/STANDARD DEDUCTION HC10
State Form 5473 (R6 / /-03) �
Prescribed by the Department of Loral Govemmenl Finance
INSTRUCTIONS: See reverse side lor /iling inslmctions.
� Y�" `� +.e�'���`�'�� T7FICATION STAIEMENT�i � �'*" � �� � 3�-�� �`�+ -""_`Y?-`�—�
�i ��''. �.�a�e-��.'�f»�i?-a�-1 �� `�C�,.�¢s.`�s:. �.. ._��'x,._.,t��� !�s-�..: _ �ta�-sc� �.�..
�(we) certify that on the 1st da of March, 2Ifi1
,I_(,W,e�) occ ed as our prindpal place oi resi e following described real property for which a Homest ��ad_Property-7� Cr.,W� he�y cYaimed:
lWf (We) ed ❑ !ve n undercontract � �' ✓JY✓,
�N 9 � IBSON COUN i Y AUDITOR �
� Have a benefidal interest in ihe en6ty that is liable for the property taxes on the pmperty and that owns the property or is buying under a conUaG. �
If byMg om m�irad, Fee Simple owners nama
Remidefs ofice where conVad is recorded
County - � To.mship � Tating
Rewrd number � Page
Is ihe pmpe in Question:
Real property ❑ A1oEile Homo (I.C. 61.1-�
i( any poAion al the resitlentlel sW cture w the land nol exceeding one (1) aae Net im Aiatey wrtounds that sWGUre is used b produce income. describe Ihe use and portion
a�wa ��� �v� �,���� ��. y'i � �tS
20Q�ay 20 Q�--j
Lesser of 1/2 Homestead
vauauon or f35.000
signetl