HomeMy WebLinkAboutHomestead_Fugate (5)e rt�� � CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
a:� '� CREDIT/STANDARD DEDUCTION HCio
f��� SWte Form 5473 (R2 / 5-92) •
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INSTRUCTIONS: See reverse side lor liling instrudions.
. . .. . .._...., . �� . . -_;.CERTIFl TIONSTATEMENT;`,-.. . _�__,.-,:._. . :-,... ., _ . .... _
I(We) _ � `�7 certi t o h st o h _
I(We) occupied as our principal pla of residence the following d ' ed real pr rty for which a Homestead Property Ta�c Credii is hereby daimed:
/-1 I(We) owned ❑ Are buying under contract N 0 V 17 1998
� Have a beneficial interest in the eniity that is liable for the property taxes on the property and that owns property or is bu ' g under a contraa.
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Y: �' �
. - - . . - . , . -.-CONTRACTRECORDEDv.. ,. � �..GIBSON UiJTY.AUD � _-.-.,..
It Wying on contract, Fee Simple owner's name
Recorder's oHice w�ere contract is recorded
numher � Page
_ _ ;, ...... � -
� - ' ' � �PROPERTYDESCRIPTION "- -=
Counry Township Taxirg Cisiricl(dry, fown, lownship)
Parcel number Legal descnption
- -€� -� � N 18-a-io , o �
It any portion of the residential swaure or the Wnd noi ecceeding one (1) aae Ihat immetliatety surrounds that swcture is used ro produce income, describe Ne use arW portion
of Ne property utilizetl ro produce income.
� PROPEHTY OWNED BY CLAIMANT IN OTHER COUNTIES �- �
Counry Tawnship Counry Township
I hereby certiry ihe above statements are true, correct and complete. Sgnanre ot ciaimam
�'ress (numberarMStreet pry, sfare, ZlPOOde)
� � ASSESSOR USE ONLY - TRUE TAX ASSESSED HOMESTEAD � NON-RESIDENTIAC. '..
- . � - VALUE VALUE� VALUE VALUE
Land not ezceeding 1 (one) acre immediately � � . . � � -
surroundin9 resideniial improvements. (�) �
Oiherfand (p) - _
Total land (line 7 plus line Z� (3)
Dwelling (4) � � �-
z
Residential improvemenis , . �
Garage (5) - `
Oiher improvements (6) �
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � (g�
I hereby certify Ihe above is lNe, corrett, and Si9namre ot Assessor Date signed
complete.
Ventyirg aclion - Sgnamre of Auditor Dare signetl
� STANDARD DEDUCTION ALLOWANCE'" •
79 Pay79_
Lesser of 1/2 Homestead
Valuation or 52,000 S
SgnaNreolAuditor y ' \l � I�a!e�9-�1 /�`
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