Homestead_StefanichCLAIM FOR HOMESTEAD PROPERTY TAX
- �° CREDIT/STANDARD DEDUCTION
�\ � �..� � Slale Fortn 5473 (R5110-01)
��� Prescribad by Ihe Department ot Local Govemment Finance
INSTRUCTIONS: See reverse side lor �ling insfructions.
FORM YEAR
HC10
�
GIB/�� � C°�i INi���
Have a benefidal interest in the enti Nat is liable for the ro e taxes on the ro e ���� �`�
� ry p p rry p p rty and fhat owns the property or is tiuying under a convad.
If buying on contraq. Fee Simple ownefs name
Recrndefs ofice whera mnVaU is recordetl
Counry
Parc�el numb�er
-I�l—
N any ponbn o/
N
County
Record number � Pa9e
� Tavnship Tating diSUitt (dty, fown. township)
Legal description Is the pfope in question:
� � eal DropeM ❑ �bile HOmo (I.Q 61A-� .
uUUra w the lantl nd ezceeding one (1) aae that immediatey surrounAS that stru re is used b produce incame, descnbe Ue use end portlon
income.
/./b �
a'�- /�-�4- /�o - �. ��9_ � r
Twrnship
I hereby certify the above statements are We, corred and complete.
Address (number aM streef, dty, atafe, ZIP wde) /
v A1[..�t S !i/r�(K � =_i✓
County
`''���..,� ��.�' ���.���� STIWDARD:UEDUCTION ALL`OMIAIiCE:?`�.x„�',,�,,�'"„�".y,'���.*�;�i.'�,�r�`�,'�,� =�.�,x�`?S�-'_�, �,
20 _ Pay 20 _
Lesser of 1f2 Homestead
Valuation or $6,000 $
Signahire ofAudrior Date si9ne�
1