Homestead_DoernerCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION ^� Hcio
` ! State Form 6473 (R817-07) N`• �'
Prescribed by the Department of Loral Government Finance
INSTRUCTIONS: See reverse side for filing Instructions.
I (We) I LZASBCW t.+ Vw U 11 certify that on the 1 st day of March, 20
I (We) occupied as our principal place of residence th following described real property f which a Homestead PV hereby claimed:
I l I (We) owned ❑ Are buying under contract GIBSON COUNTY AUDITOR
Have a beneficial interest in the entity that is liable for the property faxes on the property and that owns the property or is buying under a contract.
CONTRACT ••D s
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
ASSESSOR USE ONLY
Coun
PROPERTY DESCRIPTION.
Township Taxing district (cif own '
rcel(numb�erq �-j ^t
`( � t L> 30J QOM
Legal description I
Is the property in question:
Real property ❑ Mobile Fbme (IC 6 -1.1 -7)
If arty portion of the residential structure or the land not exceeding one (1) acre that immediately wnounds that re is used to produce income, describe Ure use and portion
of the property utilized to produce income.
ASSESSOR USE ONLY
PROPERTY OWNED B
HOMESTEAD.1
County Township
County Tavnship
I hereby certify the above statements a2 We, correct and complete.
'�19�aa'r daimam
JV
/
-ess (number arnd Cary, te, tl Pcotle) a
n
ASSESSOR USE ONLY
ASSE�SED VALUE
HOMESTEAD.1
NON-RESIDENTIAL'
$
or 43,000 for 2009 pay 2010 40,000 payable after 2012
S'
Land not exceeding 1 (one) acre immediately
y
P i
surrounding residential improvements.
(1)
Other land
(2)
Total land (line 1 plus fine 2)
(3)
Residential improvements or Annually
Dwelling
(4)
Assessed Mobile I Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus fine 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)
STANDARD DEDUCTION
Pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 44,000 for 2008
Homestead Valuation Pay 2009 41.000 for 2011 pay 2012
$
or 43,000 for 2009 pay 2010 40,000 payable after 2012
S'
Date sign e&( in
y
P i
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