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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION /
State Form 5473 (R8 / M3)
Prescribed by the Departmem af Local Govemment Finance
INSTRUCTIONS: See reverse side lorlling inslructions.
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FORM YEAR
HC10
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��e� � y that on the 1s�'day o( March, f0
I(We) occupied as our principa� place ot residence the II 'ng desaibed real property (or which a Home ead Pro a� dit is he eby daimed:
�(VJe) owned ❑ Are buying under contract C,�g/� 7Y AUDITO�
; Have a benefidal interest in the entity Mal is liable for the pmperry taxes on the property and �hat owns the property or is buying under a contract.
I( buying on [onfract, Fee Simple owners name
conireq is recorded
County
Tamship
fown,
Rewrd numDer � Paga
�celf�r ��� �/� I Legal descriDtion // � Is Ne ro �'
O v G@rtY uy W estion:
YU ���� Real properry ❑ MoWle Homo (1 C&t f-�
7"�
N eny portwn o( fAe residentlal struqure w Ua Innd not excaeAing one (1) aae Net immetliatety wnounds that sWCWre ia used b pro0uce income, descnbe tl�e uee and portion
o( the property utiltretl tu produce income.
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Toxnship
I hereby certify the above statemants are We, corted and compiele.
and sbeef. r�fy
Caunty
daimant
Tavnship