HomeMy WebLinkAboutHomestead_OdomCLA�M FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
t � State Form 5d73 (R5 / 10-01 �
�•� Presaibed by Ihe Department of Local Govemment Finance
INSTRUCTIONS: See reverse side 7or (ling inshvctions.
� �FORM YEAR
HC10
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I(We) - � cert(y thal oathe�lsl day of March, 2(1�.
k7/.-nAh iL ie/�, r�-�!*. v,—
I(We) occ ' as our prindpal place of residence ihe (ollowing described real property (or which a Homestead,P.roperty TacCredi( is here6y`daimed
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❑ I(We) wned ❑ Ne buying under contracl �
'Have a benefidal interest in the entity that is liable for the property taxes on ihe property and ihat owns the property or is buying under a wntract.
I( buying on coniract, Fee Simple owners name
Recordels olfice where conVacl is recorded
Record number � Paqe
County /(/ ' � TamShiP T ing d"(dry, t wn. fownshiP)
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P /Ij�Jumbar �(�� Lagal tlescription Is ihe 'n questio
�`� �� D O ZCJ Real pr ❑ MoD�e Homo (I.C. 61.1-� .
H any poAion ol Ne resiEentlel atructure w fhe tand not excaeCing one (1) atte Nat immediatey wrrounds that shucWre is used b produce incwne, describe the use and portion
ot Ne propBAy ulif¢ed tD pfodute ifltome. '
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20 _ Pay 20 _
Lesser of 1f2 Homestead
Valuation or $6,000
SignaNra ol Auditw
5
Date signed