Homestead_Kruse (7)�} CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
/ Sute Fwm 5473 (R6 / 4-03)
Prescribed by t�e Department ol Lacal Govemment Finance
INSTRUCTIONS See reverse side !oi liling insfn�clions.
FORM YEAR
HC10
i�
� _� � �
11 0
�(We) ���� �� ` ����A/�,�/� certi(y thal o e 1st day oi March, 20
�I(W occupi�d as our principal piace o( resi ence lhe followin�escnbed real property for which a Homestead Pro�e�d�c C(ediPi �ereby daimed¢
iJ I(We) owned ❑ Are buying under contract ��aSON COI�) ; qUDITOR
� Have a benefidal interest in the entiry that is liable for the property taxes on the property and Ihat owns the property or is buying under a wntraU.
If byvg om m�tratl, Fee Simple Owners name
Recorders ofice whera conVaa is recordeA
a .T--�n �r.�
'���a.s�?,�T�' _ ,J'^s.'"�:2rz�`.ti�`���J:.:`�2-s."�St",a..^?
County 7onnship
Record number � Page
�� ' D I 3—� O I Is ti�ie property inReal D o{rerry ❑ Mobile HomO (/.C. 67. f-7�
It any porlion of the residential sW cWre w the land na exceeding one (1) aQa Ihat immetliatety wrtounds tliat swcture is used b produce income, descnbe the use and portion
of ihe propeAy util¢etl te produce income.
a.o�.
oo-o�a. io� �as
20 _ Pay 20 _
Lesser of 1l2 Homestead
w 535.000
Signature oflwditor
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