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Homestead_GreerCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR ` CREDIT/STANDARD DEDUCTION HC7o � � State Form 5473 (R5 / 10-01) � ��M Presaibed by �he Department d Local Govemment Finance INSTRUCTIONS: See 2verse side /or �ling insUVCtions. �(We) �il:L/�L�t�L a�tKX/�� certiy ihat on the 1sl day of March, 20_ I(We) occupied as our principal place of residence lhe following described real property for which a Homestead Property Tac Credit is hereby daimed: ❑ I(We) owned ❑ Are buying under wntract � � Hava a benefidal interes� in the entity that is liable for the property taxes on the property and �hat owns the property or is buying under a conVaU. II buying on confracl. Fee Simple owners name Remrders ofice whwe coniraq is recorded Couny H eny portian c ot Ne proPerty Taxnship structure w Ne land nd exceeAing one (1 j acre thel ice income. -��/7-`fliD- `/�.� Remrd number Ta�ing disUict (ciry, tawn, fownsAiP) Page I Is the pmperty in quesGon: ❑ Real property ❑ M11�MI0 Homo (/.C. 67.1-� wrtounds that swcture is usad W produce income. descrihe Me usa antl portbn ��`'� �:'�yF . _ ' i�F " S. � �4 � . ri.� +,? �S 'v� � �cs� .. vr�w+^,��aa +t��3•,y£ytX=i.':•a ;����.,,.'���?f*�a����y'c,.�`�#�-i;STANUARD:DEDUCTION'ALLOWANCE,'.��.�P`},�,,,'�,,,,?���--�t:i.,.,�,d� �.'-zcc:,>n. � 20 _ Pay 20 _ Lesser of 12 Homestead g Valuation or $6,000 SignatureofNiditw �� Dat signed