Homestead_SchuleyCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
i w Slate Fortn 5473 (R7 / SO6)
Plesrnbed by Ihe Depertrnent d Laal Govemrtiarrt Fuiance
� INSTRUC710NS: See reverse side /or filing instructions.
W
� M'e) IU Bc
I(We) occupied as our prindpal place "Ig described real rty tor whi a Homes
�M�e) owr�ed ❑ Ne buying unda contrac[ '
ave a benefidal interest in tlie entity thal is liable for Ne property taxes on ihe property and thal owns
rc Wy'mg om m�tracl, Fee S7rt�le awrers neme
Ravders otEce where caNaa is reoorUed
�'.SGIr�"''w��M+�.`tKR'�;��dX��:., 9r.'Y`.i-�' s�'�j"'.�.a.`..5�(e
Counb ia�ruhip
Tmmig dislrict (c'ty, town. tavnshiP)
FORM
HC70
�
� ihat o�� st day of March, 20_
F�p�T�c Credit is hereby daimed:
Ir9pe�ty� is.buv�R�&nder a contracl
(J ..� P�"�
Recard number � Paga
f� ►� a4-�t��oy.'�1��=oa i (�_� o���� ❑ M�����,.�.�,.,_n
H erry Pwtion W Ihe rasidefrtial atruerina u the larid iml «ceeding one (1) aae tlial'cnmediately artaunds thal s9ucture is uaed tn produce'vimme. describe Ne use and P�n
��e��w�m��. �� N aa3-ra �. o� �
Tawnship
I hereby certify fhe above sta�rtienCs are true. caract and mmplete.
(nunbererd street �1: sate. ZlPooee)
Land not exceedirg 1(one) aae imnediatety
surtounding residential impro�ita.
Other land
Tdsl land (line 1 pluslme �
DMeltirg
Resdential improvements or Mnually
Assessed Moble / Alanufa�ued Hortre
Garage
OUier improvemen�
Tdal unprovemerAs (!me 4 fhrough 6ne 6)
Tdal value (line 3 pLa Gne n
I hereby ceAity the abwe is true. cortect. and
CoRlpl2t@.
Vaflyin9 etSal - Si�ehue of Plld�Of
(�)
lz)
(3)
(4)
(5)
(6)
i�
(8)
Sigrmtwa of Assessw
County
daimarrt
signed
signed