HomeMy WebLinkAboutHomestead_Bailey (4)CLAIM FOR HOMESTEAD PROPERTY TAX
1 CREDIT /STANDARD DEDUCTION
State Form 5473 (13215-92)
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INSTRUCTIONS: See reverse side for filing instructions.
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NOV 01 2000
CER ICATI STATEMENT
GIBSON COUNTY AUDITOR
I (We) certify that on the 1st day of March, 19_
I (We) occupied as our principal place o r sidence the following described real property for w c a Homestead Property Tax Credit is hereby claimed:
❑ I (We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
CONTRACT RECORDED
It buying on contract, Fee Simple owners name
Recorders off" where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township)
Parcel number
Legal description
UL)
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and potion of
the property utilized to produce income.
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PROPERTY OWNED BY CLAIMANT IN OTHER COUNT RTES
County
Township
County
Township
i of claimant
ereby certify the above statements are true, correct and complete.
Addr as (number and street, city, state. ZIP code)
CC I C
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON- RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Otherland
(2)
_
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assesar
Date signed
complete.
verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _ -
I Lesser of 1/2 Homestead
S
Valuation or $2,000
Signature of Auditor
Date
Li'.