Homestead_EnglertCLAIM FOR HOMESTEAD PROPERTY TAX
" CREDITISTANDARD DEDUCTION
` •q , Slate Fortn 5473 (RS / 10-01) /�/�
Presaibed by ihe Deparhnerrt of Lacal Gove(m�m�ent(F�inanyrr� 1%j N �
F/ikitl5t Cli6 �c7'�
INSTRUCTIONS: See reverse side /or i i ru ns.
FORM
HC10
YEAR
� M�8) certify lhat on the 1sl day of March, 20_
1(We) occupied as our principal place oi residence the follo described rea operty for whicli a Homestead Property Tac Credit is hereby daimed:
�C
� I(We) owned ❑ Me buying under contract � �
Have a benefidal interest in the en6ry that is liable for the property taxes on the properry and fhat owns the property or is buying under a contraG.
if 6uytr�g on conVact, Fee Simple ownefs name
Remrders olfice where conirad is recorded
County
Tamship
Taing disUict (ciry, town, township)
Record number � Page
P I num(�e,r/(� //� �y� d cripdon^ ^'� 1 Is►}y�e pmperty in question:
�0.7 l:/ 41 /��V�� p(` ��f O� / D�� I r�..� � Real DroPeM1Y ❑ MoMle Homo O.C. &1J-� .
H any portion ot Me residentlal aW dure w the land nat ezceetlinp ona (1 j ava thet immediatey wrtounds that swcture is usetl W produce income, desuibe Me use and porUOn
or the properry utJ¢ed tn praduce inmme.
� i i �ii.�c —
20_Pay20_
Lesser of 1l2 Homestead
VAuation or 86,000
$
SignaWreofP�d'Aw (,� l� �. `� l J�✓ Q IOatesig ptlr�• O
1'� 1 �o