HomeMy WebLinkAboutHomestead_Willis (8)CLAIM FOR HOMESTEAD PROPERN TAX
'� CREDIT/STANDARD DEDUCTION
ti N» � SYate Form 5473 (RS / 70-01)
P25cribed by the Depar6nent d Local Govemment F"uiance
INSTRUCTIONS: See reverse side /or filing instrucfions.
FORM YEAR
HC10
� �
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I (We) " � �i)�Q'� � � 1 � 1 f1 �� �l� / � i�� • Jn�. r.. V �___ .
Lrtiy lhat on the 1st day�of March, 20
,
I(We) occupied as our prindpal place ot residence ihe following describe al property for which a Homestea'/d Property T�1Ci� t is he�reb4�y d�med
�I (We) owned ❑ Are buying under contract R�^-^��"t•
G;BSON COUt: � v AUDITOP.�•
� Have a benefidai interest in ihe entity ihat is liable for ihe property taxes on the property and that owns Ne property or is buying under a wnVad.
If byvig on contraG. Fee Simde owner's name
Recordefs otfice where contraC is remrded
County
Tamship
Parcel numDer , � L� desaiptlon
6��-a�g4a-� ��%
H any ponion of ihe residential struchire w the land not esceedinp ane
ol iha pmperty uG7aed tn produce income.
COUnty
I hereby cerUy the above statements are We, corred and complete.
(num6ei and s4eet, city, slate, ZIP code)
Net
Is the
Record number
ImvnshiP)
Page
�a� v�vero ❑ nmaie H«no O.c. o-f. �-�
thal SWCIIire i5 used W produte Ncome. tle8tribe the uae end portbn
�
_ . ��-�� ��"-�, � -��,�-��iSLWDARD`.OE�UC710N'ALLOWANCE�'��:���r."��H>�':�'��,����.�t��
20 _ Pay 20 _
Lesser of 1/2 Homestead
Valuadon or $6,000 $
" a e of Au M � Date signed