Homestead_Wilson (2)n.
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Sute F«m 5473 (RB / 4Q!)
PreSaibed by the DeOartment of Local Govemment Finance
INSTRUCTIONS: See reverse side lor filing inshucGons.
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��e) � v�%(Qrn �� ��� certify ih � on the 1s o���r h�
I(W oaupied as our principal place of residence the following described real property for which a Homestead Pr e���r �qt ,, ebb�ip9d
I(VJe) owned ❑ Fve buying under contract
' Have a benefidal interest in lhe entity that is Iiable for the property taxes on the property and ttiat owns Ihe property or is buying under a conVad.
If buying om m�Vaq, Fee Simple awnets name
Remrders ofice where wntraq is recordetl
County
Parcel number
Tawnsnip
Legal description
ais�rict (ciry,
Is ihe
Record number � Page
�— �Q �p. ��—�/ I I C�Real P�aDeM ❑ MoWie Homo (I.C. bt. f-n
H eny portim of the resiOenUal sWCture w the Wnd not axcaeAing one (7) aae that immediatey wnounds Nat swcWre is used tn produca income, describe Ne use and ponion
of the propeM ufilized tn praduce income.
�G - /7 o3d - �a-O�• �3 7-G�/
3�- 3- /�
Twvnship
I hereby certi(y fhe above statements are W e, correG and complete.
AdEreu (number and sGaef, cd}; sfate, ZIP code)
/. G 9�',
County
"._�.• 'tVia'�'Si� - �i'FY�Yd`3 Y
:s.�"�t'"s��:_`-�� ��mra�'�-- --��'��`.;STANDARU:OEDUCTION'ALLOWANCE;N� �'L�;�y.�'�{��'it-';�.�j°'r",��'.;`{�,.<�.��`'-'A"�tu�t-"�'
20 _ Pay 20 _
Lesser of 1l2 Homestead �
VaueUOn a f35.000
Signatura oflwd'AOr � Date signed