Homestead_Wildt' CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� / Stata Form Sd73 (R6 / 4-03)
� Piesaibe0 by Na Department ot Local Govamment Finance
INS7RUCTIONS: See reverse side lw filing inshvctions.
FORM
HC10
YEAR
__. . _ _. ---. -.-.._..'._...�.. � ... -^. .<.. _....� -. -� ..,�, _ _ �
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I(We) ' • certify that on Ne ist day of.March, 20
I(VJe) pled es our prindpal piace of r ence Na following described real property for which a Homestead Property Tmc Credit is hereby Gaimed:
�n I(We) owned ❑ Ne buying under contract
Have e benefidal interest in ihe en6ry ihat is liable for ihe property taxes on the properry and Nat owns the property or is buying under a contrect.
�� buyi�p on conVect, Fae Simple awnafs name
Recordefc ofica where conVact is remNed
Counry
�U' I 9-1�,b8 �o�Cb I�d�� °,���.1 �li.Q 11
If eny portion of Na res�dentlal sWCture w Ne land not esceeding one (7) ac+a tl
ol Ne prope�y ut�ized W produce incwna.
County To.vnship
I hereby certify the above statements are W e, cortect and complete.
�sa (number errd sLeet dry, ata[e, ZlP code)
number �Paga
Tm�ing
I Is �ha property in puestion:
❑ Real proPerty ❑ Moblle Home (I C&1 7�n
surtountls ihat s W ctura �s used to produca income, dascribe the use and portion
ol Uaimant
TONllbh�p
�
20_Pay20_
Lesser of 12 Homestead
ValuaGon or 535,000
af Pu0ltor
5
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Date