Homestead_RemingtonCLAIM FOR HOMESTEAD PROPERTY TAX
'�' CREDIT/STANDARD DEDUCTION
t � SIaU Form 5473 (RS / 10-01 �
NM
Prperibed by the pepaAmeM o( Lncal Govamment Finance
INSTRUCTIONS: See reverse side for filing insfructions. �
FORM , YEAR
-HC10�` u_' � �
� '
€dOV 1 � 2�n?
, _
�(we) � certi .thaf ori�tha 1 st d'ay'of Marifi�'20'
uwovN �.Vln:7v Af��IYn_ i
I(We) oaupied as our prindpal piace idence the follo 'ng described real p erty for which a Homestead Property Tac Credit is here3y da�
� I(We) owned ❑ Are buyi under contract �
'� Have a benefidal interest in the endry that is liable for fhe property taxes on the properry and that ovms the property or is buying under a contrad.
If buy4g on conira�2, Fee Simple ownefs name
Recorders ofim where coMrea is
Caunty � Tamship
Parcel number e scri tbn
�� — � ��� �d -
N eny portion ot Me resiGential s4ucWre w Ua land nM ezceedinp one (1) aaa t�et
W Ne property uGlizeO b produce ixome.
Taing
— Q d /
Recard number
Page
Real propsrty� ❑ MobOe Homo (l.C. &1.1•� .
ue is useE b produm inmme, desuibe the uw end portla�
�''y"�*.����r�-`°';t�'`"�_'�,�-�'.��`F��,.>'z�` ��5av.-,STIINDARU�DEOUC710N'.ALLO..ANCE��'`�'Y'=Qa. "`.' ��!�'r,•�_,�'
W �*'�`'�nz:�i 4 " � �-
20 _ Pay 20 _
Lesser of 1 /1 Homestead
Valuation or $6,000
S
Sgnature of Auditw ' Date signed �.