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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDR/STANDARD DEDUCTION
rne � s4r3 �� i sa�
� P e;ubatl by Uia Departrt�ent of Lool Gorerm�aG FowrcR
wsrnucnoNS: See rever�e side /or filing msbuctions.
� _ _ / CERTIFlCATQI STA7EMENT
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�(�'�e) � � certify that on the tst day of Marrh. —
I(We) ocapied as aa prinapal pla o:: esidemo tcM1�wiry desa�ed �r�! prop:-y for which a Hmnstead Roperly Tgc C�i! (�d54ried:
�1(We) owned ❑ Me buying unda contract GIBSON COUPITY AJDITOR
Have a benefidal mteresf in fhe entity that is liade for M�e properiy hazcs on Me property and that owns the property or is buying under a contracl
. _ . . . . � . . . . .... - � � �.CGK:FACTREG�.:saEA�,,'' ,;i '
rc tuyvg om m�Uxt, Fee Si,rqle orn,ers reme — — �
F�mrdels at6ce where cartrad is rrcnrdetl Recad numbar Paga
Canh
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TurtaHp . �.". •.<'..:�
� �i'-wP.b�%a -dv �,�%�a'�.L��/��
n arry portion d Ihe residerJial ��e a Ihe lad nal �¢eadirg one (1) aoe
dNepropatlyyq6¢e�f� inmrre.
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�?lo-/..�-o�%�7O �DOo?. %a�'-,
Ihe
anraim� If�
i Gueston:
rxem v�ovF,�, ❑ �b �,e �,.c. �,_,_n
re is used m pmduce'sxoma, desaiba Me �se and pation
'�;ASSESSORUSE��ONLY: "`s
LarW not ezceedirg 1(one) ave imnediiately
s�around'aq residential improvert�en�.
Olha lard
T[f� land (I'ore 1 pk�s !me �
Resdential improvernents orMrwally �6�
As�ssed Mlahde / MarpAarLaed Hm�e
Gars �+e
rnner "vnprovements — ---
Tdal unprovernerrt: (ine 4 Mrxinh Krm F?
Tdal ralue (1'vre 3 pd�s Gne 7)
I hereby certify Ihe abwe is trve. carerJ, aM �
mrt�p1E�@.
Vaih^^Badim-Sipm�real/WdMw ____'_'__.___
2b Pav 20 .—__
Lesser M 12 Homrs��r!f
VAuaEOrl w 535.000
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