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Homestead_QueenA ^"iv , t CLAIM FOR HOMESTEAD PROPERTY TAX - � CREDIT/STANDARD DEDUCTION ` •,• � Sfate Form 5473 (RS / 70-01) Prescribed by the Department of Local Govemment Finance INSTRUCTIONS: See reverse side lor filing insiructions. � FORM � YEAR HC10 � � �L � .ILJ 1LJ �LJ' � M�e) � certify that on the 7 st day of March, 20_ I(We) o upied as our p� ipal place of residence the followi escnbed real property for which a Homestead Property T�c�G(ed�t � h�B�Gaimed: I(We) owned Are buying under contract /� �ave a benefidal interest in fhe entity that is liable for ihe property taxes on the property and Ihat owns the prape�rtyc o�6iy��u �r a conlract.�/ � � �....,.,,.,... . �.�_,��.� i �s9.4a�:c:+r�v�k-��.��w'�r��=.�'�`—��""�'�-�?'�.`��"��>CONTRACT',RECORDEDxac�i: �� i�x:�..s'ra�i�.�':�t:-:?e� oE�. ri-�:,.�° . � - If buying on conVad, Fee Simple owners name Recordefs olfice where contract is recorde0 Rewrd number Page Counry Tavnship Tacing tlisl � Iy, wn, fowns ' Py)r r �L�\q al description Is the property in questio . / ^ o�3 � a V eal pro ❑ Mobile Homo p.C. 67.1-7) I( any potlim of the resitlentlal sWClure w Ne land not exceeding one (1) aae that immediately surmunds Ihat sWCture is used to praduce income. describe the use and portion of ihe property utilized m produce ifxome. G-//-3/- �3c�o - ao�3�a - o�t � 20 _ Pay 20 _ Lesserof 1Y2 Homestead Valuati_on or 3�.000 5 � �"�/L����`• � , � � ��� «f'