HomeMy WebLinkAboutHomestead_MarshallCLAIM FOR HOMESTEAD PROPERTY TAX UJI FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
State Fenn 5473 (R715-M
Prescribed by the Departnent of Local Ca ernrnerd Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) -V Pl— %L [J/"J&ArVemFonjhe st daygr
4!M!Th,d��
I (We) occupied as our principal place of residence the following described real properly which a Homestead PropertyAvile%it s emby armed:
1773' 1 S (M) owned ❑ Are buying ndercorr1ract GIBSON COUNTY AUDITOR
lave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract
'Q�a '�� ' -��9 - gy
t 4�4WQFi� ��
If buywQ an =Ua&. Fee Simple o~s name
Reca aft dim where contract is recorded Record number Page
A h
6_4 . 1VK4 PROPERTY.omcknim6k
Canty
ToxrisNP
Taring district (CiIy; town. �I09rop))I
I Township
I hereby certify the above statements are true, correct and complete.
descnplion
Is the
I 7X;Zw!w'--ty ❑ Cie
Ham (I.C. 6-1.1-7)
Harry =rtth=e=:u.ch- or the land not exceeding one (1) sae that immediately surrounds that structure is used to produce ir�, describe the use and portion
of the e.
P Rop ERT.Y, owN ED � qyummim IN om sito u Nms I
Vll,�
�j�WEXAX' E$,
County
Township
County
I Township
I hereby certify the above statements are true, correct and complete.
re��
370TE M, Ale
08�79 end 5 9al,1 de)
47190
20 _ Pay 20 _
Lesser of 112 Homestead
Valuation or SM.000
Vll,�
�j�WEXAX' E$,
ASSESSEDNALUE
HOMESTEAD#
ESIDF
�ON4_
'g R -NMAL'�.,
1 0
'N
Land not exceeding I (one) acre immediately
0
surrounding residential improvements.
Other land
(2)
Total land (line 1 phis fine 2)
(3)
ww�
Residential improvements m Annually
Dweiii ng
(4)
E
ON
Assessed Mobile I Manufactured Home
Garage
(5)
i I W
ffi
l
Other improvements
(6)
ffinela MEN
TcLal Improvements (Fae 4 through fine 6)
(7)
Total value (fine 3 phE fine 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Data signed
complete.
VaTlying actim - Sgnstura of Audrttar
Data signed
20 _ Pay 20 _
Lesser of 112 Homestead
Valuation or SM.000