HomeMy WebLinkAboutHomestead_Heldt (14)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Stala Fortn 5673 (R614-03)
PrescAbeC by the Department of Local Govemmeni Finance
INSTRUCTIONS: See /evarse side /or filing instruUions.
FORM �
HC10
YEAR
��e) —� � J U � . certify that on the 1 st day of March, 20
1(We) occupied as our principal place of residen the following descnbed real property fo hich a Homestead Property T�,£rediti's,�eby daimed:
�I(We) owned ❑ Fve buying under contract GIBSON COUNTY AUDItOti
Have a benefidal interest in the entiry that is liable for the property taxes on Ihe property and Uiat owns the property or is buying under a contract.
If buying on conVaa, Fee Sunde owners name
Recorders ofice where conNaq is recordcW
{� �':ywr'a�'{�� v:.vi'-:r�:�.{��G-S
t �ntl�i'.�.4��.F1�-� .r� vCe.Ty'G'�i";4 �F{�r..e.4'z5J?f'1�!`li'�.
Counry Tamship
town, township)
Rewrd number � Page
Parcel number /�,��C�Q Lje�gal description Is Ihe pmp'�,�(yyin quesGon:
�d��V(�n t O V VJ Realproperry ❑ MabilaHwno(/C 6f.f-n
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If any portion ol the resdentlal sW cture ar the land na axceeding one (1) ace Inat immetliatety wrrounds that swcture is used to protluce income, descnbe the use and portion
of the property utilaetl In produce income.
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�o���Y
ca��ry
I hereby certify the above statemenls are W e, corred and complete. �� �- I Signawre ot Gaimant .
(num6er arM sbeef, city, slafe, ZIP cade)
20_Pay20_
Lesser of 1i2 Homes;ead
vawauo� w 535.000
5
SgnaWre otAuditor � \/ I Date sc etl 1` b�
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