Homestead_Hoehn (2)� � !/
CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
t yy � State Fortn 5473 (RS / 10-01)
Preauibed by the DeparhneM o( Local Govemment Finance
INSTRUCTIONS: See reverse side Jor filing instrucfions.
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MAY 0 8 2003
�(we) _�/ll/�.f..[ 1� '� lT�^ v T\ certiry that/�-1 nra `o�UiN rh�20�
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I(We) occupied as our principal place oi residence the following desaibed real property for which a Homestead Property Taa'Cr�it is hereby daimed
❑ I(We) owned ❑!ve buying under contract �
� Have a benefidal interest in the entity that is Iiable for the property taxes on the propeRy and thal owns the property or is buying under a contraQ.
I( biryug m conVaC, Fee Simple owners name
Remrdefs olfice where contract is recorded
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Counry � Tamship
Tating Oistrict (oty, fown, fownshiP)
Record number � Pa9e
Par� r _^/ � I����� �'�—� � IIsNeP�PeKYinquestion:
� O I SVl S' ❑ Real property ❑ Mobile Hqno (I.C. &1.1-� -
N any portion of Ue residentlal sWCWre or Me land not exceedinp one (1) aae ihat immeCiatety wrrounds �hat sW cWre is used b produce incane, describe Ue use and portbn
of the propeM util¢ed fo produce inmme.
ao.A�
20 _ Pay 20 _
Lesser of 12 Homestead
Valuation or $6,000
signature
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