Homestead_Robinson (2)n.
CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
State Form 5473 (R6 / 1-03)
Presriibed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side lor%ling insln_iclionsJ �_
a� FORM YEAR
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� M�e) �, Q/y `,e� �, ��J �/ i�/►L« ► 1 certify that on the tsl day o( March. 20
I(We) occupied as our principal place of residence the following described real property for which a Homeslead Properiy T�c Credit is hereby daimed:
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❑ 1(We) owned ❑ Are buying under cantrad / GI35C.'2 CG::�i Y 6,i)��7C : �
� Have a benefidal interest in the entiry that is liable for the property taxes on Ihe property and ihal owns the property or is buying under a conVact.
If buying on contraq, Fee Simple ownefs name
Rewrdels ofice where mnVaa is recorEed
County
Township
town, fownship)
Record number � Page
Parcel numDer Leg sc � on Is the property in puestion:
��D�� ��,k(r 16�3�Ip� ❑RealDroperty ❑A9obilaHOmoll.C.67.f-�.
I( any porlion of Ne resitlrntial sW dure w the Wnd not exceeding ona (7 � aae Nat immeydte�rrounds that sWCUre is used b p�oduca inoome. describe the use and portion
N the propery uul¢eA b produce income. (
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