Homestead_KellerCLAIM FOR HOMESTEAD PROPERTY TAX
- CREDIT/STANDARD DEDUCTION
♦ •Y � State Form 5473 (RS / 10-01)
Prescribed by Ihe Departmenl of Local Gavemment Finance
INSTRUCTIONS: See reverse side (or filing instructions.
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,I--(W,/e�.eccupied as our prindpal p owing described real property for which a Home d P
IS I(We) owned ❑!ve buying under contract C
�Have a benefidai intcrest in the entity that is liable for the properry taxes on ihe property and that owns lhe p Fpei
I( buying on conVact, Fee Simpie ownefs name
Recorders of6ca where conVad is recorded
FORM
HC10
Record number
YEAR
o ar , 20_
s y daimed:
3
under a conVaG.
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5 .-.'�. �.,�-_ �
Paqe
Counry iamship aisuict (dry, rown. townshiv)
Parcel number -� Legal desaiption Is Ne property in q ' n:
- 2. - � wowre ❑�cua Ho�,o v.c. a�.i-n -
H eny portion ol ihe residentlel strucWre or the land na ezceeding one (1 J ave thet immedialey wrrounds that swcaire is used b Droduce incwne, Oescribe t�e use enO portbn
ot U�e property uLT¢ed b produce i�ome.
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. 20_Pay20_
Lesser of 1/2 Homestead
Valuation or $6,000 $
SynaWraofAUditw ' . DatesgneA
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