Homestead_Helsley (3)� m
CLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT /STANDARD DEDUCTION HC10
Sx�lyrr? • State Form 5473 (R2 15-92)
\r�u IH 17 {1J�1
INSTRUCTIONS: See reverse side for /fling instructions.
YEAR
Nil
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CERTIFICATION STATEMENT`. I�� I,'`1�1r1r —� – -
I (We) certitj M'Wt on tae a99y of March, 19
I (We) occupied our principal place of residence the following described r I property for which a Hom ead Prope t Tax•Credit is hereby claimed:
[-!- I (We) owned ❑ Are buying under contract �–i ,.j i
Have a beneficial interest in the entity that is liable for the property taxes on the property and that ng:M63ITro'perly or Is buying under (a contract.
:.: CONTRACT RECORDED.,,,.:
It buying on contract. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
w:�. _, PROPERTY DESCRIPTION - .;