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,� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
/ State Fwm 5473 (R6 / /-03)
Prescribed by the Departmenl of Local Govemment Finance
INSTRUCTIONS: See revcrse side lorliling inslrucfions.
�•.L G i�
� � j� ; 7
0 C T S 1 2003
� nr,�y� v � n�—�.- ,..� ,�.----`'w
certiry lhat on�e.A'stfday.bl�March,�26�;
I(We) occupied as our principal pla of residence the following described real property for which a H tead Property T�c Credit is hereby daimed:
�i (VJe) owned ❑ Are buying under contract
eHave a benefidal interest in the enlity Nat is liable for the property taxes on Ihe property and that owns the property or is buying under a wntract.
I( buying on conVad, Fee Simple owners name
Recorders ofice where conVacl is recwdeA
Counry � Tamship
P — L al escription
i( any porlion o/ Ne resiEentlal sWdure w tl�e Wnd not exceeEing one (1 � acre ihat
ot the property utilaeE tn produce irrcome.
Tating dislrict (t�ry, fown, township)
Is Ne pro',
I
3ty rtounds Ihat
Record num6er � Page
question:
�I property ❑ Mobila Homo (I.C. 61.1-7) .
e is used b p�oduce income, descri6e the uu antl portion
20_Pay20_
Lesser of 1/2 Homestead
vauanon or E35.000
SignaLUa o(lwdil«
$