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°' � CLAIM FOR HOMESTEAD PROPERTY TAX
y> -- : � CREDIT/STANDARD DEDUCTION
te Fam 5473 (R8l 7-07)
���w � Prescribed by Ihe Departmerrt af lotal Govemmenl Finarxe
INSTRUCTIONS: See �everse side Ior filing instructions.
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� FORM YEAR
HC10
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� M�e) certify that+ulihe i st day of March, ZO_
I(VJe) occupied a ur prindpal place o} res g described real p for which a Homestead Prope �rt��:(,�ereby daimed: �
V
� I(We) owned ❑ Are buying under contraU GIBSON COUNTY AUDITOR
, Have a benefidal inlerest in the entity that is Iiable fw the property taxes on the property and that owns fhe properly or is buying under a cqntract.
If huying om m�Uact, Fee Simple ownefs name
Recorders oftice whete conUact is recortletl
number
Tamship
Legaldescription
If arry porlion of lhe residential siructure w Ihe Wnd not ezceeding ane (i ) acre ihat
d Ihe property uti6zad lo produce incane.
Taing
to:m,
Is Ihe property in question:
Record number � Papa
i
� �eal property ❑ Mobile Home (IC 64J-n
wrtounds Iha� sWCture is used lo produce inoome, descnbe the uu and porlbn
Land not exceeding 1(orre) aae immediatey
Other land
Tdal land (Irne 1 plus line 2)
Residenfial improvements or Mnually �e����
Assessed Mobile! ManufacWfed Home
Ga2ge
Other improvements
Tdal improvements Qine 4 through line 6)
TUaI value (line 3 pfis Gne �
I hereby certify ttie above is true, corteU, and
tl
compiete.
Vairyirg actim - Signature of Auditw
(�)
(Z)
(3)
(4)
(5)
(6)
(�)
ie)
Signature of Pssessor
�! pay 20 _ qs.ppp for 2007 pay 2008 42.000 for 2070 pay 2017
Lesser of 12 qq�000 for 2008 pay 2009 41.000 (or 2D71 pay 2012
Homestead ValuaSm
w ^ 43,000 for 2009 pay 2010 40,000 payable after 2072
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Date signed (rrxn(A. tlaY• Y�h