HomeMy WebLinkAboutHomestead_Sisk (7)�'""' CLAIM FOR HOMESTEAD PROPERTY TAX
, $ STANDARD / SUPPLEMENTAL DEDUCTION
State Fortn 5473 (R72 / 6-09)
�O � Presaibed by lhe Departmenl ot Local Govemment Friance
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FORM YEAR
IIV�]IRV4IIVIYJ.JOOIOYC/JCO/UCIVI,,,,,,�,,,,,,���,,,,>. JUL 1 3 ZOUy
.,
I(We) cerlify that 1(we) occupie`d'�7{qyloy�� d I
l!�r"if
place of residence or (are) ng the following described real properry tor which a Homestead Property Tax Standard Deduction isl7ereby�d' �
under coniract on ihe date mis appliration is filed, (date ol filing): GIBSON COUNTY A
❑ I(We) ovm ❑ Am (are) buying under recorded contract
❑ Am (are) entitled to occupy as a tenant-stockholder of a cooperetive housing corporation
� Have a benefidal interest in Ue trust or the right to occupy the property under the tertns of a qualified pereonal residence trust
�- • •
Name o Ua" t(kgal name) �
Sody Seariry
I Secunry num o1 Uaimanfs se (las! five dgrt Dmels Gca IdenG�ration / Oth number Issu State
f tla' sGWSe (last fiw dgiCS)
• ••� �
tt buyvig rn contre0. Fee Simple ovmeYS �ume
Recordefs of�xe where mntract is recorde0 Retord number Page
. . � • • � • •
�nry Tawnship T�iria (bf�; town, townshiP)
Parcel numbar �Ba 'p' � Is Ne property in quesiion: �ua0y assessed modle home (IC 6-1.1-n
a�i w�cem ❑
If any portial ol ihe dentlal sWCNte or Ne WM not exceed'Irg one (1) aae Ihat imme�iatey surtou s at sWCNre IS usetl In produce inCOme, tlesCribe the use an0 pOrlion
�of Ne pmperry ' 10 Produce income.
�-/a-i�-aaa-oao. G���a� C�i`
..- . , : . .
Coumy Township Ccunry Toxnship
I hereby cerlify ffie above ststements are we, cortecl and complete. Siynamre ot aaimam 1� ` �
W
Addrew(nt/mDeraMStree � ,sfate,andLPCOde) ���
11
� • • � • �
•" • ii'. �
Land not exceeding 1(one) acre immediately ��yc �rr� 5¢�r��+'��' i.'.'
surtoundin resldenUalim rovements. (�� ^�^-_*-•-�•^�-'�°�-=�"�"''"i°
E_ F'v`'sa�`�"y:iT'�P"-i.i;
Other land (2) "�M �g'�i<.a+,�,'`«�.._
Total Iand (line 1 plus line � (3)
' �+,�a���a � �C_ , y.
Residentialim rovementaorMnua ��ling (4) l 5'�w, �_�{?bK'�`�'a,,,c?.�
� P uY -�- 2` cr+' .i v.>w�,z�.
AssesseE Mobik I ManWactured Hane Garage (5) .. �,.�.';r �; Y�,�'sf{�?`�.���r;'�,i•�
i � tisry y,,}�.
Other impmvements (s) *�'� � .' �h fi`L:.
Topl improvemenb (llne e through Ilne 6j (7)
Toql value (ltne 3 pl�a Ilne � (B)
I hereby certify ihe above is true, correct, Sg"ature °f Assess°` �� �J^� P^�^�• day, year)
and complete.
VeiM�9 action - Sigfanire oflwditw Date si9ried (manN. deY. Year)
� � . • � � � • •
20 _ pay 20 _ Lesser o( 60% of Ihe assessed value of Ne homeslead or $45,000
' Notv.it�sfarding any athe�plov'�sion. Ne sum W Ne dedtn^lionc proNded In IC &7.1-12 to a moOJe fame ihaf is S
roi assassed es �eel propeM w lo a menufactured hartie fhat a rqt essessed as iesl pmperry maY �t erceed _ ' _
rne-haN ( f21 dMe assessed value ot Ne rtpbYe frome a✓manutarluied hortie.
SynaWre of PLO'vnr
Oate signed (monN, tlay, yea/�