HomeMy WebLinkAboutHomestead_Smith (32)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fartn 5473 (R6 / a-03)
Presuibed by Ne Department of Laal Govemmeni Finance
INSTRUCTIONS: See /everse side lor �ling instnx.tions.
� � YEAR
FORM � -
HC10
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I(We) /l��(�4 L( (� �,�/r// /�/CJ certi(y that on the 1sl day of March, 20
I(We) occupied as our prinppal place of residence the following descnbed real property for which a Homestead Proper r7�,Credit�� reby daimed:
�,� I(We) owned ❑ Are buying under contract GIBSON C0� TY AUDITOR
Have a benefidal interest in the entity Nat is liable for the property taxes on Ihe property and that owns lhe property or is buying under a contraU.
it buying rn mnVad, Fee Simple ownefs name
RemMefs ofica where wnVacl is recoMed
County �
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It any poRion of t�e residentlal
af�the nproPerty utilaed to prodi
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.�� -/.�_/i 9-
Tamship
s � ��1���a.X, �
aWCWre w Na land not exceeding one (1) aae mat
ice inwme.
Tacing
Is �he
Record number � Page
_� Real properry ❑ Mob9e Homo (/.C. 61. iJ)
wrtounds that Cure is used to produce income, desfiibe Ue use and portbn
;������ `w`�`""���'���'�'� �`'x���'f".�i+r �'-TRUETAX��'i� ASSESSED`VALUE� �o OMESTEAD N N-RES�OENTI,CL �'}�%
��AS5ESSOR USE ONLYz'��� ��.L ��y�UE .3 �' RAT-�t00Ye..OFiTN �"�VALUE� F{e-''��_'%���,�s ,zVALUE��'�?
d.r .,::��r�tt.�`•tRt'3�;iYa, _ �3i 2Na'ngi'v3 i, s.. _.-. >-!�.ox ..� .�c�'q2�.- a �",s., aar7�?
Land nol exceeding 1(one) acre immediately P� -+ � 'r�T,%��sa
suvoundingresidentialimprovements. (�� ��..`�� ,,,fay�`'7 � Y-?
m
Otherland 2 ����. �`e..,�z'��
( ) a-n�'��� ::_}s� - -
TUaI land (line 1 plus line 2) �3�
�_t::-s z" �"� 'S" � ::i.
Dwelling (4) �9��=��s ": � . ;.. ��a'e''�
�Residential improvemants or Mnualy �-�'`�%�'���i ' ��'y` �'�'�'
0.ssessed Mobile / ManufaUUrad Home Garage 5 %' , -� - --'. -s. y . �'�'' .2'�i :�
� ) R.;4.�'�,. �`C�3. 2 ' �c��-j_'�t" �,_Y'
°+. �'"�'.��'�,''-•�i
Otherimprovements (6) �.�r=i:-,,','nz: `+-�
- i �'4��"+�n`y�`
Tdal improvemenfs (line 4 through line 6) ��� .
Tdal value (line 3 plts line n (g�
I hereby certify fhe above is We, cortecl, and Signature ott.ssessor oate signed
complete.
Verifying action - Signature af Putlitor Oale signed
���,�*�?��+����:4n�+'�5,��'�.�.t.,��-i:STANDARD:OEDUCTION�ALCOWAlICE*rb,��.,.F�j��,,�`��L� .�;:SZr��y`;3��,`�1.�:T�e.y^
20_Pay20_
Lesser of 1�2 Homes.ead
- vauauon or f35.000 5
Signawre of NMitw � Date signetl