HomeMy WebLinkAboutHomestead_HoggR, CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
S�ate Form 5773 (R6 / 4-03)
Presriibed by the Department of Local Govemment Finance
INSTRUCTIONS: See revcrse side for Iilinq insfmc(fona
�` C 0 AR
JAN 0 6 2005
� (We) V ' � � certiry tha�a �a'G'Ot71�aAt'JD�BR—
I(VJe) occupied as our principal place of residence lhe follovring d ed real property for which a Homestead Property Tae Credit is hereby daimed:
�I(We) owned ❑ Fve buying under contract �
Have a benefidal interest in lhe entity that is liable for the property taxes on Ihe property and ihat owns the property or is buying under a wnVaU.
If buying on conVad. Fee Simple owner's name
Remrders office where conVaG is recorded
caiory /
Parcel number
__IY.C.f ��
H any poAion o
of the property
County
Tovnship
/_� /O�' Vl7 / -/
uAenfial sWCWre w the lantl not
tn produce incame.
_ �� /}9 a��_
Toxnship
township)
/ /� /'� /� Ils Ihe
one (1) aae that immediatey sunounds
, �q�
I hereby certify Ihe above statements are true, wved and wmplete.
:dres�(number eM sVeet, cify; stafa, ZlPcode) �
County
Signature of cl�aim�a/nt�
C N 'f'" "WCL m
6�.5�
Record number � Page
al D�operty " U�b�e Hano (I.C. 6f.1-n
is used to produce income, Cesaibe the use and poNon
/
��.:��.�� R'�;�-�;��..�,���STANDARD:DEDUCTION'ACCOWANCE*:��2".�: ��`�;���: �: �'.��ti�;"�K
- 20 _ Pay 20
Lesser of 1/2 Homestead
$
ValuaUOn or E35.000
Signalure aflwditor � Date signed
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