Homestead_CaseyCLAIM FOR HOMESTEAD PROPERTY TAX FORM YFJ1R
CREDIT/STANDARD DEDUCTION Hcto
State Form 5473 (R7 / 54M
Prescribed by the Department at Local Cioverntnent Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) f I �-r
� CZ-1— certify that an the 1 at day of March, 20_
1 (We) occupied as our/nncipal pleas of residence th�!/fon=o—wingdesaibed real properly for which a Homestead Property Tpi Credit ik.hem1by claimed:
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I (We) owned ❑ Are buying under contrat GIBSON COUNTY AUDITOR
Have 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
';4V CONTRACMIFtECOMED
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H on contract. Fns owner's reme -
Recorder's affte where ca di d is recorded Record number Page
PR6pERTY,owNEb�dy,ciAmANTbi'6TkEkcouWnES> +,.,,
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Tbmship
County
County
ToNnship
town. ". townstap
Taxing district (y. )
ar arid sinsak criy, state, ZIP 0)
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Parcel number
Legal description
Is the property in question:e/
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I ❑ Real property ❑ Mobile H.. (LC. 61.1-7)
tf &W portion of the residential sbix*" or One LwW not exceeding one (1) acre that irnmrKliately stmunmcks that structure is used to prod" income, describe the use and portion
at property ulif®d W produce income.
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PR6pERTY,owNEb�dy,ciAmANTbi'6TkEkcouWnES> +,.,,
County
Tbmship
County
I Township
I hereby certify the above staternents; are true, correct and complete.
ar arid sinsak criy, state, ZIP 0)
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A SESSOR USE ONLY�4." �je,
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VAOAFESTEADI-�
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kNONA-UIDENTALp',,74�,g
.41 ,
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Land not exceeding 1 (one) acre Immediately
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surrounding residential improvements.
Other land
(2)
#.";z
Total land (fore 1 phis fie 2)
(3)
Dwelling
WIN U
Residential improvements or Annually
(4)
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Assessed Mobile Manufactured Horne
Garage
(5)
X
3
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Alt
Other imWovements
(6)
Tctal improvements; (fie 4 through fine 6)
(T)
Trial value (fine 3 plus fine 7)
(8)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Vartlying action - Signature of Audrlor
Date signed
STANDARDbEDUCTIOWALLOWANCE
Yt
20_Pay20_
Lesser of 12 Homestead
Valuation or SW,000 $
Signature of Auditrx Date signed