HomeMy WebLinkAboutHomestead_Hamm--- ---�- - -�-- �..-.
` CLAIM FOR HOMESTEAD RROPERTY TAX
° CREDIT/STANDARD DEDUCTION
t J Stete Form Sq3 (R6I I-03)
«
' Prascribed by ihe Oepartmeni of Local Govemmeni Finance
� INSTRUCTIONSr See �everse side 7w filing instructlons.
I (We)
I (Wel
.
FORM �� YEAR
HC10
the st day''M L. h, 20_
�p14d�6ufprindpal place of residence th�rollowing described real property for which a Hom�t�ad Rro�rtv TmtdCrBdit fS he by Gaimed:
Y g g " �' �
� rnvned ❑ Are buying under conVact
a benefidal interest in the entiry that is liable for Ne properry texes on the property and ihat owns the pr�y �r i8b�ndar e conVect.
If buying on contred, Fee Simple ownefs name
Recardefs ofice where conVact is reeorded
Counry
W
Tovnship
GIBSON COUNTY AUD1TOit
Racord number PaBa
legal description pihe property In question:
eai v�verry ❑ MaWle Home (I.Q G7.1•�
or the land not esceeding ona (7 ) ave that immediatey surtaunds Nat sWCtura is used lo produce income, describe Na use and poRion
I hereby certify the above statements are We, correM end complete.
f
/_ss (number end sVeet, city, ataro, ZIP code)
not exceeding 1(one) acre immediately
mding residential Improvements.
Otherland
TUaI land (Nne 1 plus line 2)
Dweliing
Residenlial improvements or Mnualy
0.ssessed Mobile / ManufaGUred Home
Garege
TUeI Improvements (line 4 through lirre 6)
Tatal value (Ilne 3 phs line n
I hereby certify the above is We, correcl, and
compiete.
V¢riymp action - Signature oflwditw
20_Pay20_
Lesser of 12 Homestead
Valuation w 535.000
of Puditor
i�)
(Z)
(3)
(4)
(5)
(6)
�)
(8)
SignaWre of Pssessor
�
S
DaU signed
Date siBned
_ ' :.n?. � r: ..
� Dete s' r3e� �