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Homestead_SimonCLAIM FOR HOMESTEAD PROPERTYTAX CREDR/S7ANDARD DEDUCTION smte Fo�n ss73 (R7 � s0� PresabeA by Ihe Depmfiianl ai Loml Goramierd Feiariae INSTRUC710NS: See reverse side lor filing instructions. � FORM HC10 � �.:. . � ' . ::W ::�7AA-n �. .._ ....:... .. . :. . . .. ,... .. . . . .-. _a, . � . . , ..c.- .. . . . _ I(We) certiN th�a► ai 5�E'1 ��'d5lyot Merdi. 20_ I(We) oxupied as av prmdpal plare of residence the foAowirg desa�bed real propeAy for whid� a Homestead fiq�rly Tmc Crecfit is hereby daimed: �I iWe) owned ❑ Me buy'vg unda cantrad �/( �� Have a benefidal mfere� v� the entity Biai is liade Gw ihe poperty f�es m ihe p�opaty arM 9�at owns IBie �prop�r���ij�YTi$pr a contract .'1* t i�! ' i�.�C%�C�m�:"c:s t�.u, �`A�{�d'�y;5'•� •. 1� i.rv,°"ri�l�.ti.i �:.Y�'�.9<?r:ir'�.Fi: M Wy"vp m cmhe4 Fee Sin�le wxnere reme ..:� Rafartlefs dfice wRiae mrllafl is iemded Remrd number Pa9e � � .�. Tnnskp�;. �""n ��"(J`i"I�' `�vTIDC��—�1 IbUie M arry pwtion of Ihe resder�tial �ae v the IaM nd m¢ea6ng ane (1) ace tlmt inrtedmtey amaa� d tlie praperty Wif�d Oo pmhce uimme. i1 q�0on. V v �poperry ❑ Mo6ib Home (LC. 61.1-n � Lae is used b P�duce iimnie. dex�ta fhe �ae and paton � 1rahY )�..:' x 4..� .. siYPr. _. f it �._ t_• �: � � 3 ,. SA`...a�r. , �'�ORIUSEONLY�.i3.•� �fl �1�5e�" VALUE 1 � ''AT��1�QF-TIV, fa°.b�.� ���+� ����.t�-hi5�i:..V�:ID@m� 8�...`>� land not e�¢eeding 1(one) aae irtrr� "' �'s u�,.fi. ?�+�`,<'� `����%�t��aF°�"� (`''-'' s�aramdirgresidentialirtqxo�ertwnts. �7) y�a'�ix�..;Fa�,.!+,et.��z:}:-:�S;v%�j?��i r . Otl�er land (2) ,�'m-J a'f� in 5; Ttl� Fand Qure 1 phrs 6re � �g) �9 ( ) :,e,�zi�i��%��"V.,=aii -� ��,'ti{�: Re9dentialvrproveme�tso.avwa�y oweR 4 _.,:v� u...,s�'e...,.,s��s.��...>r��'�.�� Assessed MobBe / AlaraifaWaed Flame ��Je 5 'v$ u��.�,`,a[F;��.3GllY✓'1 A��;���, sN+ "�` ( ) � � Y�"� �i.h.u�;.::,�N.e�i��,;�ia�,v��� 1` OM�er unprwernents (6) ` :' `, � , . . ..r. �'r- x . Tdal'vnprovemer�s (ivre 4 Bwu� ffne 6) �7� Tarel value (lure 3 pds ffne n (g� I hereby cc7tify the above is true. carted. and S�e�� of Assessar Da1e sigied complete. . v�a�ry�re aaian - si�ama orart�mr oem si�ed 2b _ Pay 20 _ Lesser of 12 Homestead Valuafian w S35.ODo S