HomeMy WebLinkAboutHomestead_ConnerCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Slate Forth 5073 (R8I7-07)
Proscribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
`n� J FORM YEAR
_ HC10 �.
F I L
I (We) t A VA Ai Act' L,,,(n!N'ffl Q—k- certify that on the 1 st day of March, 20_
1 (We) occupied as our principal place of residence the following described real property for which a HomesteadBrADc',''j/d' It is hereby claimed:
I (We) owned ❑ Are buying under contract O �'�r v
Have a beneficial interest in the entity that is liable for the property taxes on the a and that rn GIB COUNTY AUDITOR
property the property or is buying under a contract.
CONTRACT RECORDED
If buying on central, Fee Simple owners name
Recorders office where contract is recorded Record number Page
County
I hereby certify the above statements are true, correct and complete.
street. city, state, and ZlPcode)
7&60
ASSESSOR USE ONLY
TRUE TAX VALUE.
ASSESSED VALUE
HOMESTEAD
NON-RESIDENTIAL
DESCRIPTION
County
--PROPERTY
Township
Tsung district (city, town, township)
PaTel numb
/C GYl
Legal description Uc/
I Is the property in question:
❑ Real property ❑ Mobile Home (IC 61.1 -7)
any portion of the residential structure or the [arid not exceeding one (1) acre that immediately surrounds that structure is used to produce Income, describe the use and portion
of the property uliGmtl to produce income.
County
I hereby certify the above statements are true, correct and complete.
street. city, state, and ZlPcode)
7&60
ASSESSOR USE ONLY
TRUE TAX VALUE.
ASSESSED VALUE
HOMESTEAD
NON-RESIDENTIAL
AT 100% .
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
V.
Total land (lime 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile I Manufactured Home
s-
Garage
(5)
.-
}
Other improvements
(6)
z
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed (month, day. year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day. year)
20_pay 20
Lesser of 1/2
Homestead Valuation
or
Signature of Auditor
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
43,000 for 2009 pay 2010 40,000 payable after 2012
Date signed (month, day- year)