Homestead_Martin (2). ' CLAIM FOR HOMESTEAD PROPERTY T �. FORM YEAR
CREDIT/STANDARD DEDUCTION � �X� p ��
t Stste Fwm 5473 (R6I403) �\� ,"-
' Prescribed by tha Department of Local Govemment Finance � J
� v
INSTRUCTIONSi See reverse side Por filing instrtxtions. (���> �
__. ,.. ---._.. _ �_.. _.�. ..>..._.,..,... ..A.__.-. . . --- ------' -°' - ... . .. . . ,.,......�.. ...: � - ...-. .
I (We) � . � . � . . . _ . - - -"� � � certify Nat on the f,� � 20�
I(We) occupied as our principal place of residence the following descnbed real property for which a Homestead Pro��s7�� 7Y A daimed:
Q�I (VJe) owned ❑ Pre buying undar contreci
DITOR
, Have a benafidal interest in the entlry that is liable for Ne property texes on the property and that owns Ne property or is buying under a conVact.
,'�.•.:-?:z.r.��c.?�?..t,"c�r:�;;: _.v� F,�-.-:y' za»i�'S=�t s=rCONTfL4CT�RECORDEDS:,.f ;.=-v-a.c -s t�,,:;�. ,i...-.
If buyuig on contract, Fea Simple^ownels name
Recordelc o!fice where cwiVeq is racorded Retord number Page
3:xi'.`at�ax ��. fi2�'� +..�._�".. ,v`.2„" '�`�- isT+s3'%<'�'' 'ri„°,x...'" ,tt�P.ROPERTY.:OESCRIPTION?: ^� °C . '"� _ir.t, � ., c ,:.. , .
�.ctiv :,-..r� .` r..:.€h - t-�r:u
Cwnry Township Tmgng district (ciry, town, townshiDl
Parcel number L al desaiption Is Na propertl-y iIn Question:
� - c� � d � - � �ilo� �-3- � a °4 . � a3 pa Real D�Perty ❑ Mobile Home (I.Q 67.1-�
If any portion o( Ne residential sWC2ure or Ne land rwt ezcaeAing one (1 J eae that immeEiately surtountls Nat sWCture is used to produce inwme, descnbe Ne usa and portion
of Me qoperry utllized [o produca income.
a�-��_ o�-l-ioG -�y�3�� - oa l
County � Twvnship
I hereby certify the above statements are We, cortect and complete.
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