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� CLAIM FOR HOMESTEAD P.ROPERTY TAX
' CREDIT/STANDARD DEDUCTION
� SUte Fam Sn73 (R6I403)
' Rescrihed by Ne DepartrneM of Local Govemment Finance
INSTRUCTIONS: Sea raverse side for �Irng instn�ctions.
� - y,� �--- -
FORM YEAR
HC10
�
��''�e) a' � `IJ certify i-��h--ayyyt ,,,o,,,n th��-e tst dey of�.March, 20 �
I(We) occupled as prin I placa of residence the fdlowing described real property for which a Homestead P��'y "�'�E,is hereby daimed:
�I (We) owned ❑ Are buying under contraa GIBSON COUNTY AUDITOR
Have a benefiaal interest in the enliry that is liable for Ne property texes on Ne property and that owns Ne property or is buying under a conVact.
�r buy�ng on convect Fae sin,ple ovmers neme
Recorders afflco where conVeq Is recortled
",�.�.'a"Y,�'...''r: K���t�u ���E.�Y',��'.?�:'<
. ��,,Y_.'.
Counry . . iamship
P/at�cel n�ujmber I !
V �'1.- �, 1 1- C�
If any portion of ihe residantlal strucwra w Ne
of Ne property utlihed W protluce incoma.
number �Paga
rown,
aescnP on -7 Is the proparty In quesUon:
'4 � ( ' � � ` � � � �al proPeM1y ❑ Mobile Home (I.C. 67.f-7)
not exceeding one (1) aae that immediately surtounds Nat sW cture is used to produce Incoma, describe Ne use and portion
f�t�s°.,,���A-st_L.�ryP �=�:4,"'r,�ic ��' z ,��.,� �'� 7RUE�TAXo'fi' ASSESSEDV/iLUE HOMESTEAD � �� � �' .. .. . �r �
�c_„{�'2„�r,. zASSES30RUSE�ONLY �'k y�s"'i- �S y,q�UE�'* P'�� AT',100%OFT7V�' �:�VALUE 4r ���NON-��RESIDEN�IAL�, r.
.. r.s'd ...�'..��.�.�c.sa.a.n,.-�xz2=-�'a�4'�-1.... . t ... ;.� ..._. _ t_. .. _^-.....,� ._.1;'.- ' , . � �.., '�.:�, VALUE:..*..SZ?":.. ��
Land not exceeding 7(one) acre immediatety ;ij'� '� ,. �:�Y �_}y�-�i`tvl� �' "=�
- �') (y�l � ' � T-sJ�� �'j li
surroundingresidenUalimprovements. .. � .r; r.;s.,..___;.�,:=,�x_,,��;,�
v
Other land (y� t' � �'s� ,',.'.
_ „t; .t�w
T<!al lartd (line 1 plus 1/ne 2) (g�
Dwellin 4 ;�in°4`>x�,�,` ���.�f.�s.,>c> �� .Y�4
�Residential improvemenfs orMnually 9 � � �q�'}^M%�`..e.���},,'� N,';rr .-6�
AssessedMobile/Manufac4uedHoma Gara e �{'` �'����� �`�� r
9 �5) .,�? �,,e,bt� � �7 4_,� �, Xr
' �� ��.
O�pei improvements (6) . ;�.
Ttlel Improvements (line 4 through lirre 6) �7�
TUaI value (line 3 phs line n (g�
I hereby ceRi(y Ihe above is We, correct, end � Signawre oiAUessor Dau sipned
complete. �
Verilyu�g atUon - Signatura aflwditor . Date signeE