Homestead_Gibson (6)CLAIM FOR HOMESTEAD PROPERN TAX
CREDITISTANDARD DEDUCTION
� Stata form 5473 (R6I4A3)
Prasaihed by Ne Department of Lorsl Gwemment Finance
INSTRUCTIONS: See reverse side lor filing inshuctions.
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JAN 2 2 2007
I(We) l X/� Y1ii.(.. �L� Yr]/'Yi'� certify that on the 1st da of Ma �h 2Q..
(1LI�TV P�iP11v*—
I(We) occupied as our principal place of residence the (dlowing described real property for which a Homestead Pr�� �rEdit is hereby daimed
❑ I(We) owned ❑ Are buying under wniract
' Have a benefidal interest in the enGry that is liable for the property taxes on Ihe property and that owns the property or is buying under a wntract.
If buying om m�Vact. Fee Simple ownefs name
Recorders otfice where conVad is
County
�
If any porlion <
ot Ihe property
Record number � Page
7armship Tating districl (dfy, lawn, fownship)
IO Legal deu � tio � Is the property' question:
Real propeRy ❑ Mobile Homo (I.C. 67.1-7)
sWCture w the Wnd not exceeding one (1) aue that immediately sunounds that s Gura is used lo produce income, describe 1ha use and portion
ice incame.
7�
''`�'`�� y��''� �'''��'� � °¢ ���� �`�"TRUETAXj'�"� � ASSESSED`VALUE -'�HOMESTEADx � � � i
� .. .F�ix AS5ESSOR 11SE ONLY "�7�-�` -�= ��� �' � NON=RESfDENTIAL'�'.� �
x.���,c-��z'��ai:d�.`t��'�'.r"0.�..�v,���,�'3��VALUEr���.AT100°hOF,..TTV�'�`^'�`�VALUE�F ��45�,�.yVALUE�,yT�,�`t.$��
?+s,a, o.
Land not exceeding 1(one) acre immediately � ���,�.,�; 4;v v`,�,�'�y�.'< �� «`
�,, �.,
sunounding residentlal improvements. ( � .4#�,��'�,�'1��,�',�.?.' r_
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Other land �Z� '��'�=V-"'
�_ -��� s�
Total land (line 1 plus line 2) (3�
Dwelling (4) `�y�^28����z^,��'-_... ,! r�iw'�
�ResidentlalimprovementsorMnuaity � '�'�, ��''�
/assessed Mobile / ManufacNred Home Garage 5 ��f �., .a . �;,r _F,
( 1 `�.'�,.�7����� . `rs..�.75 a�
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Otherimprovements (6) '$,3 �
�..r H Ai�
TUaI improvemenLs (line 4 through line 6) (�)
TUaI value (line 3 phs line n (g)
I he�eby certi(y the above is We, correc�, and Signature olASSessor Date signed
complela.
Veriying at�ion - Signature oflwdiWr Date signed