HomeMy WebLinkAboutHomestead_BorcheltCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Stete Form 5473 (R614-03)
Prasuibed by Ne DepartmeM of Local Gmemment Finance
INSTRUCT10N5: See ieverse side /or filing insbuctions.
FORM
HC10
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YEAR
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�(We) V// 1..1'if�l UA/�i X. (/L� � //��/�•,i( J�P(t'✓y tl{at on tlie`�ay o�nar`��
I(We) occupied as our principal place of residence Ihe (ollowing descdbed real property for which a Homeslead Property';Tae GediGishereby daimed:
❑ I(We) owned ❑ Ne b�ying under contract GIBSON COUNTY q DITOR
�!iave a benefidal interest in Ne entity that is liable for the property taxes on the property and that owns the properry or is buying under a conVaU.
If huying om m�trad, Fee Simple ownefs name
Remraefs otfice whera mnVad is reoorded
�F��-'��.�-- :.s'7jTe:r:•'i-�u�a'-'.`s�"�v';��`ax'��
Counry � N �n, iavnship
�/ �� I Legal descriDtlon
tl any portion of Ihe residentlal sW Cura w Ne land
ot Ne property ulilized b produce income.
County
Tating disiritt�Q
l
Is Ihe
Record numDer
❑ MoCile Homo
Page
67.
ane (1) aue that immetliatety surtounds that swGUre is used b produce inmme, Cescribe the uu and portlon
—i � �i .c ii� �
County
I hereby certify the above statements are W e, correcl and complete.
ZlPCOde)
Toxnship
20_Pay20_
Lesser of 1/2 Homestead
vauanon or 535.000
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