Homestead_Sparks�,} CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
�� State Form 5473 (R6 / 4ai)
Presai6ed by lhe Departmenl of Local Govemment Finance
INSTRUCTIONS.- See �evcrse side loililing inslrt�clions.
FORM
HC10
�` � ��
� �,
J1 s... �
YEAR
Ii(we� � Y� / certiy ihat o�ihe 1st day of March, 20_
I(We) occu as ou principal place of residen follmving d scribed real property for which s�Homestead�Froperty_T�e.Credit iehereby daimed:
,� � 1'� '
WI(VJe)owned ❑ Arebuyingundercontract " Ggg.7i1C0U'I' ^l%��TOR �
�� Have a benefidal interest in Ne enlity Nal is liable for the praperty taxes on ihe property and that owns the property or is buying under a conUaG.
I( buying on conVacl, Fee Simple ownefs name
LOnU'dCli5reC0ld¢d
Counry
Toxnship
Tacing tlistrict (ciry, fown,
Record numEer � Page
Parcel number Legal description Is the pmp�j(y,��n question:
o� 5��� 9�►-� p t � 5 w 3 i- a- lr !'LJ Real 7roDertY ❑�a�a ��o o.�. �,.,-n
H any portion of U�e residentlet sW cNre or Me land nd axceeding one (1) ace Ihat immediatety wrrounds that swch�re is used b produce income, describe Ne use antl ponion
ot the property utilaed lo produce income.
a . � `7 a.�,
County
- �3 ao - C�3.
Tavnship
I hereby certi(y the above sWtements are We, correct and complete.
(num6er arW streef, city, sfafe, ZIP oode)
County
of
Twvnship
`���°'.i'�Te'��+.3s`"'�.5.'i r�If�="�-.a.+�'"��?�r�r:��ST/WDARD:OE�UCTION�ALLOWAMCE`�A���k'�,.''�3�Gi;i`v«�'b�-..six.�����_�`E�.��'��-'�:�
20_Pay20_
Lesser of 1/2 Homestead
veivaLOn a E35.000 §
Signature of Aud'Aw " Date signetl