HomeMy WebLinkAboutHomestead_JamesCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
FORM YEAR
C1
I (we) X Ic _12� certify thaf-A 1 0a ,
ge March, 20
I (We) occ�w as our phncipal place of residence the following describygreal property for which a Homestead Pr, pe y Credrt'Ohereby claimed:
❑ 1 (We) owned ❑ Are buying under contract GIBSON COUNTY AUDITOR
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.
ONTRACT.RECORDED&n�"��
If buying on contract. Fee Simple owner's name
Recorders office where contract is recorded Record number Page
PROPERTY,
County
County
Township
Taring d* trict (city, to", township)
I hereby certify the above statements are true, correct and complete.
Parcel number
iQzj - 00 /
Legal description
Is the prope question:
Real property ReMob.l.
e'
Home (I.C. 6-1-1-7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that shsure is used to produce income. describe the use and portion
of the Property Utifl[Zed to produce income.
13 ;?oa -egoo, 00-1>
'A PERTY.OWNED BY CI!A[AkANtlk'6TkEk"66iiAtltg a
County
Township
County 7�;Vnship
I hereby certify the above statements are true, correct and complete.
Si nature of clalmant fPn ;l( ,
/ ' 0 6z
code)
VALUE'
Wss
-ASSESSORtUSE ONLY
-TRUE:TAX,
'MVALUE-'�'--",�
ASSESSED,VALUE
-ATAOOO/'O
�-uHOMIffg`TEAD
yi I
$
FT.Tvg
� VALUEIV�,�,
VALUE'
Land not exceeding I (one) acre immediately
surrounding residential Improvements.
Other land
(2)
Total land (line I plus fine 2)
(3)
Dwelling
(4)
4
MEN
im" A
Residential impro
improvements or Annually
- vt�=— 'Mr. *�fmg
Assessed Mobile I Manufactured Home
Garage
(5)
V MIA,,
Other improvements
(6)
A "6
Total improvements (line 4 through fine 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
. . . . . . . . . . . . . STANDARD-DEDuCnOWALLO
RW 20 Pay 20
Lesser of 112 Homestead
$
valuation or 535.000
Signature of Auditor