Homestead_Raney� � CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� State Fortn Sp73 (R6 / 1-03)
Prescribed by the Department of Local Govemmenl Finance
I�TRUCTIONS: See reversc side (or liling inslmcfions.
FORM
HC10
YEAR
� M�e) �� certi(y that on ihe 1sl day of March, 20_
I(We) up as our principal pla oi residence the f owing described real pmperty for which a Homestead Pr� T�c C�edit is he� yila�:
f/�' I(We) owned ❑ Ne buying under contract �� k,I l
� Have a benefidal interest in ihe entity that is liable for the property taxes on the property and ihat owns lhe property or�s�buying under a contraU.
..rn , _ nnn�
County
P �� =0 0.4{—..J11��
H any poAion of the residentlalsW d
of the property util¢ed tn produce in�
�� - �D
�':-�?_����.��'��
County
Toxnship
al aescri tion ,� ';s ilk propert�y�in �quesUon:
� � �� �' �� / � �OG�G. _ .1� neal pro ❑ MoMla Home (LC. G 7. 7-� .
w Me land nd e:ceeding one (1) aae that immeEiatety sunounds ihal sWCture is used to protluce income, tlesaihe the use and portbn
I hereby certify the above statements are We, corred and complete.
(numberand sVeet city, s(ate, ZIP
Land not exceeding 1(one) arae immediately
surtounding residential improvements.
Other land
Tdal land (line 1 plus line 2)
Dwelling
Residential fmprovements orMnuatly
Asse�d MobOe / Manufac�red Narre Garege
Other impravements
Tdal improvements (line 4 through line 6)
Tdal value (line 3 pha line n
I hereby certify the above is We, corred, and
completa.
Veritying action - Signature of Auditor
20_Pay20_
Lesser of 1Y2 Homestead
vauenon w 535.000
Signature oflwdita
(�)
i2)
(3)
(4)
(5)
(6)
I�)
(8)
Signature ot Pssessor
$
of da"unant
Date signed
Date signeA