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Mobile Home_Hoke •!t?i.‘ CLAIM FOR HOMESTEAD PROPERTY TAX • FORM YEAR
Air ,1i,' CREDIT/STANDARD DEDUCTION HCIO 1\K MP
S ! State Form 5473(R4/e-00) - - .
INSTRUCTIONS:See reverse side for filing instructions.
u- : €re, ,'',; A1. Jy//}!CER��TIF,12;n•.ISTAmmENT ;,,- ti -+ - 'y=l: s" �3,....• rA
I(We) -,1 1 • ��' t r raelei,J� �t : tir rtify that on the 1st day of March,20,, ,, .
I(We)occupied a-'our principal place of residence the followi 1- cribed ±I property I which a Homestead Property Tax Credit is hereby claimed:
❑ I(We)owned ❑ Are buying under contract
®'lave a beneficial interest in the entity that is liable for the property taxes on the property and that ow T,- t - •-i••=i or i i g n a contract.
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+,., , .,:'i,?.4- r"a#utC§E''s,. � sWscr .60NTRACT:
