HomeMy WebLinkAboutHomestead_BrysonCLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDMSTANDARD DEDUCTION
State Form 5473 (R7 I 5-M
Proscribed by the Departrrent of Local Governrnerd Fwanae
INSTRUCTIONS: See reverse side for Ming instructions
BAN
".%'•.,J39CIMCATIONSPIENENT "PI
I (we) aAZ5:�j that on the da��
(We) occupied as of principal place of residence the kAkywing described real prope4fix which a Homestead M
kF, I (We) owned F-1 Are buymg under contract E
Have a beneficial irclarest in the entity that is liable for the property taxes on the property and that owns the property or is bwyftur*f\acontract.
-AW
If buynt; on mnbal, Fee Sffnpie ownees name q
GIBSON COUNTY AUDITOR
re number
Recorder's office where contract is conied Record I Page
DEDUCTION ALLOWANCE
V�
- PROPERTY DESCRIPTIOW-t-�
CmInty
Township
Tn ahip
Toorig district (city. town, fownsNp)
Parcel morlber
I
Laal description
AI—F li6d
Lf7 9A C
/ ff - ;1, -8
Is the property in question:
1 ❑ Reel =�z ❑ Mobile Horne (I.C. 6-1A-7)
H portion of the resbantial structure or the 12rW not exceeding one (1) am that unffmKiialety surrounds Mat structure is used to Produce in=. describe the user arx1porbm
of t,jvopefty utilized In prod" noome.
0
0.
DEDUCTION ALLOWANCE
t1*. I 'PROPERTY OWNtb BY cLAWAPit
tN Owat cOuNtMswI
County
NON4
Tn ahip
County
Township
I hereby certify the above statements are true, coned and corriplete.
roof \
Date somd
A-
DEDUCTION ALLOWANCE
TRUE .TAX.
ASSESSED VALUE
stHOi1ESTEAO -
NON4
ASSESSOR USE ONLY
'VALLE i.j
Valuation or 535,000
P,
Sqnatwe of Auditor
Date somd
Land not exceeding 1 (one) am i ffrnediadMy
surroundkV residential iffqxoveffbents.
W",
Other lend
(2)
Tctal land (Ane 1 plus firte 2)
(3)
Residential irnprovernents or Annually
Dwelling
(4)
�Y.
Assessed Mobile I MarxdacbAed Horne
Garage
(5)
"Ni
Other ff"Viernents
(6)
71
TcW (fore 4 through Eno 6)
(7)
Tctal value (Im 3 plus Eno 7)
(8)
I hereby car* the above is true. cared, and
Sqnaue of Assessor
Data ia
cmlpwe-
vaTWq action - Sqnature of Aef"
Date signed
DEDUCTION ALLOWANCE
RW 20_ Pay 2O_
Lesser of 112 Homestead
Valuation or 535,000
Sqnatwe of Auditor
Date somd