Homestead_Gibson�� � CLAIM FOR HOMESTEAD PROPERTY TAX
` ' CREDIT/STANDARD DEDUCTION
'> � Siate Fotm 5473 (R4 / &00)
INSTRUCTIONS: See reverse side for filing instructions.
FORM � YEAR
HC10
I(We) certify that on the 1st day of March, 20_
-r-� � "��
I(We) " as our principal place of residence the following described real property for which a Homestea'� ro� Tac Credit i_ s hereby daimed:
�� ir••+ fi ;�
I(We) owned ❑ Are buying under contrad �i I I / 1{._f
.iave a benefidal interest in the entiry Nat is liable for the property taxes on the property and that owns the property or is buyjng under a contrad.
It buyirg on wntract, Fee Simple ownefs name
Recordefs ofice where coniract is recarded ..
Counry
Tamship
It any pwtlon ot the residential s Wcture w ihe land not exceeding rne (1) acre that immediatery surtounCS that struUure is u
of Ne property uGlizetl to proCUCe income. - � - -
-//-.3.3 -/OU -
Record number . � Page
to protluce inmme, descnbe Ihe use and portion