Homestead_Upchurch° CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
` 1 State Form 5473 (R8 / 7-07)
Prescnbed by tha DepsrUnem of Loral Gavemment Finanoe
INST]tUCTIONS: Ses reverse Side Por filing insWc6ons.
I(We) ocwpied as our prindpal place of residence the
1(We) owned ❑ Are buying under contract
�'�LE
F YEAR
�Vl� Hc�io 1 200
���
GIBSON CO�NTy qUp�rno
�'�1 L_J certify fhat on the 1 st day of March, 20_
described real property fw which a Hpnestead PropeAy Tmc Credit is hereby daimed:
Have a benefidal interest in the enfity ihat is IiaWe fw the property faxes on the property and that o�ms the property or is buying under a contrad.
Caunry
Parcel number
Township
descnpUon
Tmring
I C-� V KJ /'7 —OC —/ � / �/A
I! arry paUon of Ihe residarNal sWClure or Iha land not �ceedirg one (1) acre �hal immediatNy surtour
ot Ihe PmPanY wBzetl In Pmduce incane.
al�-,�-�y- 3a� - c�y- 3 �a -oa�
oo��ry
Tavnship
I hereby�certiy the above shatements a2 We, cortect and rnmplete.
tion
�' �
. . .� • .
ii.•
Land not exc�rg 1(one) ave immediatey . ��"� -5j.'� �`� '�
wrtoundirg residential improvements. (�) :•, .: <._- .t :.— .
Otherland (Z� -°.s�_ •:'r�'f�_:ri::`;=� _ _
Tdal WrM (line 1 plus line 2) �g)
Dwelling (4) i��°��3�:�e` {�•t °;- :
Resdential improvements aMnually ��.;,-r�`ar"' � �:,^�."��"a;.:�;
l�s5e5sed Mobile / M3nuf2CWred HOrne `, S�.ae,�":� + �c T., y-c .
` ,�*s `iE'r�-�.,� »'�,>t �^ ��
Garege (5) `a'.c sr "��is ai :'�
r,S�I_:"`{��'?`,_'fh • ).':ia`: �_..%.: i s ..': �
y j::
Other improvements �6) ,� ?'rs�x � �z•
.,;-
TUaI improvements (line 4 through Grre 6) �7�
Tdal value (line 3 p48 Grre n �g)
I he2by Ceftify Ne above is We, CorteCt, and Signature ofASSessw Date signad (monfh, day, yea�
complete.
Verifying adion - SlpraWre oflwditor Date signed (monN, tlaY. Y��
Z.i pay 20 _ qs�p�p for 2007 pay 2008 42.000 tor 2010 pay 2017
Lesser oi 12 qq,000 for 2008 pay 2009 47.000 tor 2017
Homestead Valuation paY Z�� 2
a 43,000 for 2009 pay 2010 40,000 payable aRer 2012
SignaWre of Fwdta