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HomeMy WebLinkAboutHomestead_HippCLAIM FOR HOMESTEAD PROPERTY TAX ' CREDITISTANDARD DEDUCTION t�- � State Fwm 5473 (R5l 10-01) °N Presaibed by Ihe DepartmeM of Local Govemmem Finance INSTRUCTIONS: See reverse side /or filing instructions. FORM} YEAR H�i fi 1-� � tl / Arrc 2 2 2003 � - � � M'e) , cert(y that on'tli� istd�y�of Ma�ch; 20_. I e occu 'ed as our rin ' � lace oi residence the followin de 'bed I ro e for which a Homestead Pro e T� Credi isFre�reb� daimed R ,�M,/�� ) W P P 9 P hY P MY �� Y ���7 (We) owned ❑ Are buying under wnl2ct � \ � Yiave a benefidal interest in the entity Nat is liable tor the property taxes on the property and that owns the property or is buying under a conVaIX. If b�ry'vg on conirad, Fee Simple owners name RecorEefs office whe+e mntrad is remrdetl County Tavnship Parcel numher L�al d�e�scrip,tl,on /� Is Ihe �j(��i -' (i�a�i�--� o�aQa U:C.uo /�� uc. H any portion o/ the resiEentlel atructure w Ne land na ezceetlinp one (1) ave thet immediatey surtounds ot Ne property ulilized to produce income. County I hereby cerfity the above statemenls are We, correcl and complele. Address (nnumber �an/d sbeef, ciry; sfafe, ZIP code) � /7 /.�-f: % �nv �g / f2 Recard number fown, township) Page question: �I DropeM ❑ Mobiie Homo (/.C. 61.1-� . te is used W protluce inmme, desaibe the use antl portion 20 _ Pay 20 _ Lesser of 1/2 Homestead Valuation or $6,000 $ SgnaWre ofAudita �� ' � D � n I Date sgneA