Homestead_PlumerCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Sfate Fortn 5473 (R6 / 4-03)
Prewihed by the Departmeni of Local Govemmenl Finance
INS7RUC710NS: See iererse side for filirg ins6�ctions.
FORM
HC10
��
�� �
YEAR
1 + MNl + -
��e) �� � �^ L� ���r�� certi(y that on lhe st day o( March, 20
I(We) occupied as our principal place of residence the following described real property for which a Homest � �tedit is hereby daimed:
❑ I(VJe) owned ❑ Are buying under wntract � pUNTy AUD�T�R
' Have a benefidal interest in the enti that is liable for the ro e taxes on Ihe ro e and ihat on�sg �N C
�Y P P rtY p p rty wrc5 the property or is buying under a contract.
I( buyinq on conVad, Fee Simple owners name
Recordefs ofice where conVac� is
Co�nry
Tamship
disiric� (city, town. IownshiP)
Record number � Page
umber Le al descri tlon I
5_� ��� ��., ^ 9 P Is the ProOe O^Realstio�n:e
�
�V p p rty ❑ Mobile Homo Q C 67 1-�
If any portion of the residential sWCWre w Ne Wnd not exceedinp one (i) aae l0at immediatey sunounds Ihat sWCUre is used b produce income, dewibe Ne use and portlon
ot ihe properry uWized m produce income.
Counly
Toxnship
I hereby cerUfy the above sfatements are We, corted and complete.
(numbe��nd�{neet, ciry;�Ctate, ZlPcade)
Land nol exceeding 1(ona) acre immediatety
surrounding residentlal improvemenis.
Other land
TUaI land (line 7 plus line 2)
�Residential improvements or Mnually
Pssessed Mobile / Manufac[ured Home
Other improvements
Dwelling
Garege
Total improvements (line 4 through line 6)
TUaI value (line 3 pl,s line n
I hereby certify the above is Vue, correU, and
complete.
Veritying action - Signature of Antliror
�QASI)� ��
�TRUETAX �
� VALIJE;�, -
(�)
IZ)
(3)
(4)
(5)
(6)
(�)
(8)
SgnaNre otAssessor
—�O� �
Twvnship
Date signed
Date signed