HomeMy WebLinkAboutHomestead_Shadwick (2)� CLAIM FOR HOMESTEAD PROPERTY 7AX
s CREDIT/STANDARD DEDUCTION
♦ / State Form 5473 (R6l r-03)
PrescnDed by t�e Department d local Govemment Finanr_
INSTRUCTIONS: See revcisc side loi (ilinq insfrur.lious.
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FORM YEAR
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�,...:d.::eit..�:,;_..,._,._..,,�,..:.__..._. ...;;_. CERTIFICATIONSTATEMENT` -.- . �_
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��e) � e ify that`�3'Ef t,�par�arch. 20
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I(We) occupied as our principal place of residence the foilowing descnbed real property tor which a Homestead Property T re i i�� aimed:
� I(We) owned ❑ Are buying under contracl
GIBSON COUNT� l�tl��
� Have a beneficial interest in the entiry ihat is liable for ihe property taxes on the property and that owns ihe property or is buying under a contract.
If buying on convact, Fee Simple owners name
where contract is rewrded
Counry
Tavnship
CONTRACtRECORDED
fown. rownship)
Rewrd number
Page
nParcel Qnumber Le�y �`I' sc�ric0.��o� M Is ihe D�openy in queslion:
l I I 1— �/ rX� S� -� \�1 ln � p ln W(� �� [�eal pro0erry ❑ htabile Homo (l.C. Sf.7-7�
I( any poAion ot ihe residentlal sWCWre w Ne WnE not eaceeding one (1) aae that immetliatety surrounds that sW<ture is used lo produce inwme. describe Ihe use antl portlon
of Ne properry uWized to produce inwme.
?'`�^''`� '' �"?.r.�-"" � � `"`�PROPERTYOWNED��BYCLAIMANTiN.OTHER'COUNTIES � - � "
s�..ta � , .,.� <>
County Tavnship County � Toxnship
1 hereby certi(y lhe above statements are W e, correct and complete. Sign wre of i nt
dtlre (num¢�r aM Street, dry, sf ZlPcode)
G/ C
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� j,Y s 4°'� ASSESSOR USE ONLY _ : : TRUE TAX ASSESSEO VALUE � i�HOMESTEAD - NON-RESIDENTIAC.�,
x,n,:�.y�+..u..�.�.-:If....,.-4r=".+•• ..� ' � VALUE � AT100/d.OF.TiV .�T 'VALUE"'':' .. �::]..VALUE:-�"'.. �
Land not exceeding 1(one) acre immediately - �-
surtoundingresidentialimprovements. (�) - - . � .
Otherland (Z) � - -
TUaI land (line 1 plus line 2) (g�
Dwelling (4) �-'i�
Residen6el impmvements or Mnualty ''`� �
Assessed Mobile I Manufacturad Home Garage (5) f . _ ,
- �,3_._
Other improvemenis (6)
Tolal improvements (line 4 fhrough line 6) I(7�
Tolal value (line 3 phs line n (g)
I hereby certity the above is lrue, cortect, and signawre ot nssessor oate signed
camplete.
Ventying action - SignaWre of FwOitor Date si9ned
�� '= �STANDARDDEDUCTIONALLOWANCE"_�� �
20b5 Pay 20O �
Lesser ot tl2 Homestead
v�uauon or535.000
S
o/Audito^r� - Datesign^e�dC.
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