Homestead_Rexing(���CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
/ S�ate Fwm 5473 (R6 / t-03J
Presrribed by the Departmenl of Local Govemment Finance
INSTRUCTIONS: See reveisc side /orlilinq ins6ucfinns.
FORM YEAR
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�i certiy Ihat on the 1sFday of March. 20 �
/y^^-'-�-ni/1,. �-.c�[/.�. 19 r
(We) occupied as o r princip I of residence the (ollowing descnbed real property for which a Homestead Propertydac,Gedi4is�hereby.dauned
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I(VJe) owned ❑ Are buying under contract
Have a beneficial interest in the entlry that is liable for the property taxes on ihe property and that owns �he property or is buying under a contraU.
If buying on coniraa, Fee Simple owners name
Recordefs ofice where contraq is recordetl
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Counb Tamship
Tating dislritt (Cify, fown, fownship)
Parcel number Legal description Is Ne pml
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N any portipi d Ne residential sW cWra or Ne land not exccetling one (1) arre Ihat immetliatey wrtounds that
of the propery utiized tn produce i�ome.
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Record number � Page
que5lion:
¢al property ❑ MoDile Homo (l.C. 67.7-n
'e is used b produce income, desfiibe the uu antl partbn
20_Pay20_
Lesser of 1Y2 Homestead
vauanon or E35.000
Sgnature of Auditw
F
Date signed
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