Homestead_Money (5)CLAIM FOR HOMESTEAD PROPERTY TAX
�° CREDIT/STANDARD DEDUCTiON
� � State Form 5473 (RS / 10-01)
�w Presaibed by Ihe Departmerit o( Local Govemment Finance
INSTRUCTIONS: See 2verse side /or filing instructions.
''� "'` ' ��"{'"'��='�CERTIFICA7101
. �ti£�£��..`�m'f�.��:��A��� '-�"�.�'°:���
1 (Wel • Q l,��t� �T
I(We) occupied as our prindpal ce ot residence the following described real
FORM YEAR
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• certry that.o� tl% 1sf�tlay ot Ma- rch�0_
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Homes�fea �rope� ?�i"Cieditls"r�ieuqdaimed:
uiddaU�a GpU7�TV qUDIiOR �
❑ I(We) owned ❑ Are buying under contracl '
�Have a benefidal interest in the entity Mat is liable (or the property taxes on Ne property and that ovms the property or is buying under a contract.
I( huyinq on conVap, Fee Simple ownefs name
Recordefs o16ce whera m�ap is recorded
County
Tamship
7aing aistrict (riry, rown. townshiP)
Record number . � Page
r� C/ � DC�I �/ I-w I!1� ��/7C !� I 1 I Is Ne GroPertY in quesUon:
❑ Real Droperty ❑ Mobile Homo (I.Q bf. f-� -
N any portion of Me residentiel sW cWre v the d not esceeding one (1 � aca Net immediataty aurtounds ihat swcture is used W produce income, Cescribe Ihe uee and portbn
ot the properry uu7'¢ed W pro0uce income.
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