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Homestead_RenderR� � CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION Sute Fwm 5473 (RB 1493) Prescribed by �he Department ot �ocal Govemmen� Finance INSTRUCTIONS: See reverse side Ior /iling msln�ctions. FORM YEAR ` �' k{HC10 �_. [� �i n 1u �:�J 1S� AUG 1 � 2003 � . , . � •, � ,-„ .�- � I(We) 'fy Ihat�on the_1st day of March,20_ r.�, L�� �. _ . I(We) occupied as our principal place of residence e following described rea property (or which a Homestead Properry T�c Credit is hereby daimed: ❑ I(We) owned ❑ Are buying under wniract � Have a benefidal interest in the entity that is liable for the pmperty taxes on ihe property and that owns the property or is buying under a conUaU. I( buying on conVaq. Fee Simpie awnets name Remrtiers olfice where wnVacl is recardeA Tavnship It any ponion ot the residentlal swcWre w the Wnd of Ne propeAy utilizetl to produce income. � i i -iii — ane (7) aae ihet tlistrict (tlry, _ V County � Toxnship � Caunty Record number � Page Is the property in que3linn: � Real praperty ❑ bila Homo (I.C. 61 7) � s that s IXure is used b produce income, describe the use antl poNon Tavnship I hereby certiy the above statements are true, coved and complete. Si n�re�aiman, t � IAdd ss u erandshee(,ciry;sfate,ZlPcode) 14�� �I��1 (�r� �2�E R1 O�.,c�.�.,i ll<. 2A/ ��/_f.S