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HomeMy WebLinkAboutHomestead_MachonCLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION SYeta Form 5173 (R6 / 4-03) Piwaibed by tM OePerOmerrt d Local Govemmmt Finaxe INSTRUCTiONS: See rayc+so a6da br �tp iqburb'ont. 1�' � FORM YEAR HC10 �� u ,� 1LJ I(We) v� certilv�that on t e st day of March, 20_ l"/a�-. I(We) occupied as r principal place of residence Ihe following described real property (or which a Homestead Property a��f;redit is hereby daimed: h, !�. We) owne ❑ Me buying under contract GIBSON COUNTY AUDITOR � Have a beneficial interest in ihe entity that is Iiabie for the properly taxes on the property and that owns the property or is buying under a conUact. I( buying on coniracl, Fee Simple ownefs name County Parcel number If any poNOn of ot the properry i whera coniracl is remrded Tovnship r�� Vrn� sWCWre w the IanA nW ice ifxome. oneft) Remrd number � Page townshiP) Isthe pro m quesfion: _ �Real Droperty ❑ MoElla Homo (I.C. 61.7-� wrtounds Ihat swqure is used b produce inmme, desaibe Ne use and poNOn � t •� ti ,�''� �>.��..,��_.' ' � � � �...».+.s,y � . *•� .L +.�.+. `tx k -�. �, �ni-�- bASSES50R�USE ONLY . � � t� �,� f � TRUE TAX�r�,� ,ASSESSED VALUE � ��OMESTEAD' ��y" �iNON-F2ESIDENTIAL �:� �,�•d,e, . -+-�+�cw„£{���;,_��-�. ��''� VALUE�.�,� _AT 100/a'AF�TN.�, �F^°.PT�VALUE� 2�s�as�S..,�.,VALUEo-ai�z^�t,�� Land not exceeding 7(one) acre immediatety ��`� „�`i �?�"��yD".� ��S-�a•+«. e�.�, surtounding residential improvemenLs. (�� �` J "''�`�q"�x' ��s& `v� �f:.3° ��R.-"�+i�y` :a.TFe� J�'St: � . Otherland (2) n��_� a:Y�?C� Tdal land (line 1 plus line 2) (g� �.r��1'° ���`� = Dwelling (4) � rt � z� � ,:• � �Residantiel improvemenfs or MnuaOy `�'"A"�" '�'��'�'� � Assa�ed AAo68e / Manufactured Hmie Garage (5� ��''�t'�� Y�;- o�� iz -,-�°.�5���,L� � a �� �'���J Other improvements (6) ��� � --.'�... .'35.c_,:o Tdal improvemenLS (line 4 fhrough line 6) (7� Tdal value (line 3 plus line n (g� I he�eby certi(y �he above is We, torted, and Signature o(ASSessor Date signed complele. Verifyin9 acUon - Sgretura oflwdimr Date sgned 20 _ Pay 20 _ Lesser of 1/2 Homestead vauabon a 535.000 5 SgnatureofPLdilor " _ �Dates'gned