Homestead_Wright (18)' CLAIM=FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� I State Fortn 5473 (R6 /4-03)
� Presafbed by the Dapartrnent of Local Govemment Finance
INSTRUCTIONS: See reverse side lor filing instnictions.
FORM YEAR
HC10
I (We)
certify that on the isi day of.March, 20
I(VJe) oxupled as our principal place of real property fo hich a Homestead Property Tmc Credit is hereby Gaimed:
i� I(We) owned ❑ Are buying under contract
� Have a benefidal inierest in Ne entiry �ha[ is lieble tor Ne property taxes on the property and that owns Ne property or is buying under a wnVact.
�� buyi�B m �pnVSCt, Fae Simple owners name
Recwders oftice where convaq fs recwded
Caunry
�
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Racortl number paBa
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TownshiP Tmring district (ciry, town, fownship) ..
� � �.S � — ihe praperty in Question:
L � � ❑ Real property ❑ Mobile Home (I,Q &7.7-7)
sWCture w the IaM not ercaeding one (1) acra that immediatey surtounds that sWCture is used to produce income, describa Ihe use and portion
ira incoma.
County Twvnship
I hereby certify the ebove statements are We, correct and complete.
�sa (number and sLea4 ury, atate, ZIP code)
County
of Uaimant
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� � SlOnatura
20 Pay 20 _ I
Lesser of 72 Homestead
ValuaUon or 535,000 5
Y�l'.'1'✓l����s i�' �