HomeMy WebLinkAboutHomestead_Davis (21)� i CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
j Sla�e Fwm 5473 (R6 / 4-03)
PreStnbed by the Department d local GovemmeM Finance
revcrsc side Ior /iling ins6ucfions.
FORM YEAR
HC10
' .`
_ � _j. ..�--c A �
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I(We) ���/� �/(��f�. ceNfq�lhat on ihe 7st day of March;t20 /I
� 7
I(We) oaupied as our prindpai place oi residence Ihe following described real property for which a Homestea �d�Property Tac�Gedit is�hereby da�xned:
❑ I(We) owned ❑ Are buying under contracl �d Gissori cou:71� �,:uu�TOfi t
' Have a beneficial interest in the entity that is liable (or the property taxes on the propeAy and ihat owns the property or is buying under a wntraU.
If byvg on conUaq, Fee Simple owners name
RecoNels ofice where mntraq is recorded
County � Tawnship
P n be 'D��,^ U Legal e
1(J ✓OL
H any portion of Ihe residential strucWre ot Ne Wnd nol
W the Pro7e�tY utiized la proEuce i�ome.
County
one (7) ane ihat
I hereby cerUfy the above statements are We, wrrect and complele.
city, state, ZIP
Tating dislrict (city, tawn, fownship)
County
Record number � Page
pmperty in question:
❑ Rw aoc�m ❑ �bf�e Homo (LC. 67.1-�
that sWCWre is used to protluce income, desaihe the use and portion
Toxnship
�
20 _ Pay 20 _
Lesser of 1/2 Homestead
vaWaUOn or 535.000
5
�ata ygne0 ^ / � ' O
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