Homestead_Wilkerson (15)� CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT/STANDARD DEDUCTION HC10
S1ate Fwm 5473 (RB / 1-03)
Prescribed by the Department of Local Govemment Finanre
INSTRUCT(ONS: See revorse side larlling instructions.
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��-;4`d �-:a�.r••}}�''3�� ^�:� : rr�-�. a�w..y:.�:v'CERTIF,ICATIONSTAiEMEM.'✓T A�3 �- : . '`.-,�,. � -
...in.S:ai...: £�:,+�C�"-:..�a`�a.�,,.- .,.-.:i� . v .'C:!s_ � '� . S' - �' ° n4 .
.... •
...___ ____._ . . w.i.�r__...:""' '..�....r. ..,...-, �<_..
��, I(We) � p/�-� certi(y that on lhe 15Hfa$of�Aa ctr20�
I(We) occupied as r principal place of residence Ihe following described real property for which a Homestead Property Tmc Credit is hereby'�daimed:
'�. ❑ I(We) owned ❑ Fve buying under contract r�! ,/
/Y�J�
� Have a benefidal interest in the entity Nat is liable for fhe properry �axes on the property and that owns the property�o�fld,�.unt9er a�cdriEr�act�R
If buying on conVacl, Fee SimD�e owners name
coniract is recorded
Cwnry � Tawnshi0 � Tai^9 Ej�tpLy (riry, town.
Record number � Page
P y# !yrtq �� _ /�� I L tlescriptlon �n �� I Is the Property in qeu�eswoaM ❑�dle Hwno (I C 61 7-n
F%/y _� �� . �Q .
H eny pwlion ol ihe residential strucwre w the land not exceeding a�e (7 ) aae ihet imme0iatety wrrounds that suuciure ia used to praduce income, desvi6e Na use and porUOn
at ihe property utilhetl b produce income.
�`''i�'�.�s�it�`°'�F'ta;se�'��'^''.�.i':��,�ltices�rv�"�'Fy"'; -°.��`"'Y_=r`5`.°:STANDARU;OE�UCTION'AL'L'OWAHCE"�.�r.:�;s .. .J-�x • n�a �-.�i` `. k;sS'".e�4r �',F's.:�•z'"t`,..,�..;
20_Pay20_
Lesserof 1/2 Homestead S
VewaLOn or f35.000
SignaWreolAUditw " Datasigned