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CLAIM FOR HOMESTEAD PROPERTY TAX
` _'. " CREDIT/STANDARD DEDUCTION
t�� State F«m Si73 (RS / 10-01 J
Pmsaibed by ihe Deparhnent of Local Gwemment Finance
INSTRUCTIONS: See reverse side !or filing insfructions.
�� ;` ,' •YEAR�
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JUN 19 2��3
�/��J /�� „/„ � � e...� / /O GI3SON Ci�U�'v qU'JITC
I(We) (.V V! d (�(1��4(1�� /Vi certify ihat on tha 1sl day of March. 20
I(We upied as our principai place oi residence the following described real property for which a Homestead Property Tac Credit is hereby daimed:
1(We) owned ❑ fve buying under contrect
� Have a benefidal inlerest in the entity that is liable for the property taues on ihe property and that owns the property or is buying under a conVaU.
II byv�g om m�irad,.Fce Simple owners nama
Recordefs office where conVaa is recorded
Counry 7amship
P rcel number scription
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I( any poAion af Me resiOenUal sW cNre w the Wnd not exceed' ne (1 aae �
ot the pruperry uGfizeE tn produce income.
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Record number � Page
(city, town, township)
I Is Ne pmperty in uestion:
� yi neal propeM ❑ Mobile Homo (I.C. 6f.1-� .
atety wrrounds that sirucWre is used W produce income, desuibe ihe use and portion
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