Homestead_MontzCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� State Fwm 5473 (R614-03)
Prescribed by lhe Department of Local Govemment Finance
INSTRUCTIONS: See �everso side lor /iling insfmc(ians.
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FORM YEAR
H ,o SEf i � 'LUU3
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I(We) � �""�-�'� L, O ceRity lhat on the 1sl day of March, 20_
,I�(V,J�e) occupied as our prindpal place oi residence Ihe following described real erty tor which a Homestead Property Tac Credit is hereby daimed:
Ld'I (We) owned ❑ Are buying under contract �
� Have a beneficial interest in Ihe enGty that is liable (or Me pmperty taxes on ihe pmperty and that owns the property or is buying under a wnVact.
I( buying on conVaq. Fee Simple ownefs name
Couny
Parcel number
/�a5-<
H any poRion of
contraccis recoreed
Ta�msntp
Legal description
Tacing
Is the property in
Record number � Page
�� —� I I [�Real property ❑ Mo6ile HOmo (I.C. 6f.1-n .
�itlentiai strucNre w Ne land not exccetling one (1) acre ihat immediatery wrrounds that swcture is used lo produca incame, describe Ne use antl portion
b produce irrcome.
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