Homestead_Middleton�� CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
' CREDIT/STANDARD DEDUCTION HCio
! S�ate Form 5673 (R6 / 4-03)
Prescribed by the Department ot Local Govemment Finance � �.�
INSTRUCTIONS See revcrsc side Ior liliny �nslrucfions. i�H{!',
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��e) certify ih3t bre�the 1� day of March. 20
I(We) occupied as our principal place of residence the (ollowing descnbed real property for which a Homestead Property T�c Credit is hereby daimed:
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❑ I (VJe) owned ❑ !ve buying under contract ��, ; .y ��, �
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� Have a benefidal interest in Ne entiry that is liable for the pmperty Wxes on the property and �hal owns the;p{opeity' oris�buNng under a wntract. �
If buyirg on tontract, Fee Simple ownefs name
Recordels affice where con4aq is recordetl
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i��'�.�."����hH�-q•� L��.�r�
Counh Tuvnship
I( any poAion oi
o( the property i
Remrd number � Page
district (ciry, mwn, lownship)
^ f the property in question:
p( • �� ❑ Real propery ❑ Mobile Momo (/.C. 67.7-�
strucWre or Ne land not exceeding one (1) acre that immeEiatety sunounds that sWCture is used to produce income, describe the use and portion
ice inmma.
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