Homestead_Newman�
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� CLAIM FOR HOMESTEAD PROPERTY TAX
- • CREDIT/STANDARD DEDUCTION
�` � ; Sla�e Fortn 54,3 (R5 „0.0„ _ r
Prescribed by the DepaAment of Local GovemmeN Finance �'� 3-
INSTRUCTIONS: See reverse side /or filing instrucfions. {1 A� I G ��
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�'=r �€"�7 � � -'i'=� " e'-?"�` ,��,.�� `:':CERTIFICATION STAlEMENT'? . _�
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I (YVe) /%%
I(We) oaupied as our cipal place o residence the following descnbed real property for which a
FORM
HC10
��� � �
YEAR
that on Ihe /ts!t day of March, 20_
�tooe[lv TaEC.Credit isherebv daimed:
I(We) owned " LJ Are buying under contract �O GIBSON CvOUM? • qi �D1T0�
riave a benefidal interesl in lhe enGty thal is liabie for the property taxes on the property and that owns lhe pmperty or is buying un er a contract.
r;Y=.�'�r�z:�txs"�,"� _�i.. ?�«i�-1..;3�s. `:�'.5.'�Sn` �CONTRACT�RECORDEDrze?f,'` -...�'°+.-�-'..�5`s,:"�"-�:���.�;rs +" .�_'-'�„rt' ��J-,�. _
tl huying on conVact. Fee Simple owners name
Recorders olfice where contracl is recorded Rewrd number Page
�C � I Tavnship
d
II any poMion ol lhe residenGal strucWre w the Wnd not exceeding one
ol the properry utiiized to praduce income.
Cbu-0���/ S'-
tawn, townshiP)
/� I Is ihe property in queSGan: �
� ❑ Real property Mobile Homo p.C. 67.14)
immetliatety surtounds Nat s',ructure is used to O��uce income, dewihe the use and portion
=s�a2�;^.CN"-�Z a:.�.x-�.�zc'7i�t#.=��.5�`�.,--�`.'r��si �-�-n:STANDARU:DEDUCTIONALCOWANCE.-''�'v;•'i:i+lt.�.a.'�as�a.'z`�,�x�3 ""�`?{`��r.?t��;:"..'`"i.+.=
20 _ Pay 20 _
Lesser of t!2 Homestead
Valuation or 56,000 5
Signature oilwditor Date signe0