Homestead_HuppCLAIM FOR HQMESTEAD PROPERTY TAX
CREDR/STANDARD DEDUCTtON
�ne rbrm St73 (R7 � sa6]
Prsoib�l by the De�l of Lool GorermreN Finanm
INSTRUCTIONS: Sea reverse side /w filing instructions.
�
FORM
�/ HC10
YEAR
OEC 4 ,n
�(We) ! - ��rMy mae on me i u eay ork���, zo_
I(We) ocapied oiv pm�apa! place o:: esidenc�e the fclla.iry descrSed -_f prop^^v for a Hmwstead Tmc Credit is h,(e!re�by daimed:
��(We) owned .❑ Me buying unda contrad � C/ � V
Have a berefidal mteiest in Me enory that is liade for Me property ta:es m the propeAy and that owns the pr�0+��kW��Ynd� ��d6i�ac�
� - � -CCN7FALT-RECCBUEp..`. - : - .
. . . . . .�_.. , _ . . . �. . .. ��. .
rc a,y.g on �a,caa. rce Sino�e a�„ers reme
f�wrdefs ofice wt�e caNad is recvded Record number Pega
Coinry
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Twrahip
T�g dairicl (r3y, Inwn.
popaly en ques6on:
� Q Reel prapvty ❑ Madb Home (LC. 6f.1-n
M arry portion d tha �esidaraial strumre u the I�d ra1 eceedi�9 one (1) aae Uot inmed�y airtam� tl�a1 �uC4ae is uaed b Woduce i�mrtie. desmbe ihe �ae and pdUOn
dthe praperry wr�a ro nmmlrn imm�ie.
�a,�.c�P �a�-/�-o�-�� �31,��-oai
� � ___STAMDARiI OFSri;CTp1! GU:enva4CL -". . — _ _ , r _ — � ��
� 20.. Pav2b __r----"—'.
Lesser of 12 HomecMS�A � (
Valuation or 535,000 I S