HomeMy WebLinkAboutHomestead_Vanvliete'�5i"°- CLAIM FOR HOMESTEAD PROPERTY TAX
° CREDIT/STANDARD DEDUCTION
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INSTRUCTIONS: See reverse side !or (iling inst/uctions.
CERTIFICATION STATEMENT
GIBSON COUNTY AU
I(VJe) � certify that on ffie 1st day of March, 19_
I(VJe) occupied as our principal place f residence ihe following described real property for which a Homesiead Property Tax Credit is hereby claimed:
❑ I(We) owned ❑ Are buying under coniract • �
❑ Have a beneficial imerest in the entity that is liable for the propeRy taxes on the property and that owns the properry or is buying under a contract.
CONTRACTRECORDED
If buying on conVaa. Fee Simple owners name
Recortlefs office where convact is recorded Record number Page
PROPERTY DESCRIPTION
Counry Township � 7a�cing tlistrict (ciry, fown. mwnship) �
P n ber Legal deuription ^
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If any portion of the residenBai siruaure or the IanC noi exceeding one (1) acre ihat immed'u�e surtounds that sVUC[ure is used to O�oduce i�ome, describe the use and portion ol
Ne praperty utilized ro produce inmme.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry TownsNp Couny Township
Signa r f daima
•ereby certity the above statements are true, correct and complete. �.
Address (num6er ana sireeG ciry, stale, ZIP code)
: « P�� ��h 6�
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately (��
surrounding residential improvements.
Oiherland (2)
Total land (line 1 plus line 2) (3)
Dwelling (4)
Residential improvements
. Gara9e (5)
Other improvements (6)
Total improvemenis (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certi(y Ihe above is true, GOrreCt, and Signature ot Assesor Date signed
complete.
Verifying action - SignaWre ol Audiwr Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead S
Valuation or S2,000
Siqnature of Auditor Date si ned
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