HomeMy WebLinkAboutHomestead_Greenwello CLAIM FOR HOMESTEAD PROPERTY TAX
�,. _�,• � STANDARD / SUPPLEMENTAL DEDUCTION
State Fortn 5473 (R72 / 6-09)
•�' ,�„ r Prewibed by Ihe Department of Laal Govemment Frence
INSTRUCTIONS: See raverse Side 7or filing insf/uclions.
FORM
HC10
I�,
r `�
YEAR
ED
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1(We) certiry Nat I(we) occupied as my (our) prindpal
place of resi nce or am re) buying the following described real property For which a Homestead Properry Tax Standar�p,�eid uction is. ereby daimed
�,u_n,d(er mntraU on the date Ihis applicalion is filed, (date ol filing): �" �� �
pSLI (We) wm ❑ Am (are) buying under recorded conVact GIBSON COUNTY AUDITOR
�Q Am (are) enlitled to occupy as a[enan45[ockholder oF a cooperaWe housing corporaEon
� Have a beneficial interest in Ue wst or the right to occupy the property under the terms of a qualified personal residence wst
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Name of imant al neme) �
�
Sodal Smi num6ef of
Sodal Seartiry numbel ol tlaimant's spouse (lasf five digifs) Drivefs frtnse I Identification I ONer number Issumg State
ot daimanYs spouse (Ws! five dlgih)
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If buying om m�trec4 Fee Simple wmefs name �
Remrdefs ot5re where rvnvaa is remtled Remtl num6er Page
..�. . � � .
Couniy �/ � Twmship T' sUict (�il�: town. townshi0)
� (J /`� TV �
Pa(cel num6er Legal �' Is Ne mpeny in ques6on:
Real property � MnuaAy assessed rtwd'le home (IC G7.7-7)
�If any of ihe residenlial swaure w Ne IaM nol excee0ing ane (1) aue ihat immeGiatety surtou s at sWCWre is used �o produce irrowne, des�ibe the use aM partion
of the peny uotaed to p�oduce income.
a�-�r-�3-ao�c�i 7.3o-oa�'
-.. . . : . .
Coumy Township Counry Township
I hereby certify the above statemenu are we, cortect and mmplete. Siqnawre of d�mam �
/ Add2ss(numberantlstreet.rAy fate ndZlPCOtle)
(` 7ao !�� . ��:N� �, I,,,�� � �71z o
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Land nm exceeding t(one) acre Immediatety � �a�f �'t'� g�� r�;%%' �'?'
surtoundin residential im rovements. ( � �'-�w-h.� L-s= ���w'.€.�:e
Other land (2) � i�: �:'�:������S���x�`:
_:� uy�,
7ota1 land (line 7 plus line n (3)
Dwelling (4) `�'�'id.>�d�yS-�'��� Y+�'�`��
Residentlal improvements or Mnuatty ' x`' ��- �� rt '�
v= v Y"=;z�,ruy � � -fri"^:
Auessetl Mobile I Manu(actured Home Garege (5) ��, xx.'R �-� �,�^w�-� '� ���
.:r�'a� ��'_r`e:..
���•=Y;: _�.�i�'-`�...: �y�,._
Olher impmvementa (C) �_:.:i_,._ _.'.�r�".i"�:
���.._... R .ia.'
7otal impravements (line d Nrough Ilne � (7)
Total value (line 3 pl�s line n (8) �
I here6y certify the above is true, correct, Syrian�ra of nssessor Oate signed (mrnfh, aay, yea�
and complete.
vairyinq action - signanre or a,ditor �� s� (^�^N. �r, r�d
�.•� � � • •
20 pay 20 _ Lesser of 60% of Ihe assessed value of lhe homestead or $45,000
NolwiNStardirg any olherpmvis"nm, Ne sum ol Na tlMUrliwis provided in IC G7.1-72 ro a mobile homa Ihat is g
roi arse.ssed as real properry w fo a menu/eflured hwne Net is rot essessed as real pmperty maY �� esreed �
mehatl(12) d Ne assesse0 rdlue a1 Na mobde fame wmanu7actuied hm�e.
55nature d Audiiw Date 5igneE (monN. daY. Y��