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Home My WebLink AboutHomestead_Ellis�� *xrE a YEAR CREDIT/STANDARD DARDTDE DEDUCTION PROPERTY TAX FORM i HC10 r State Form 5473 (R2 / 5-92) E FIL INSTRUCTIONS: See reverse side for filing instructions. CERTIFICATION STATEMENT Mg 09 2oni 11 (We) c that on the 1 st d y of Ma _ I (We) occupied as our princip I pl of residence the following described real property for which a Homeste Propee he ed: ❑ I (We) owned ❑ Are buying under contract 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. CONTRACT RECORDED If buying on conuact, Fee Simple owners name Recorder's office where contract is recorded Record number Page PROPERTY DESCRIPTION County Township Taxing district (city, town, township) ParcellIrr,�,u,mber 0 /�� v O� W Legal description P U If any portion of the residential structure or the land not exceeding one (1) acre in ediately surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income. PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES County Township County Township reby certify the above statements are true, correct and complete. ignature of clamant Address(nu er and stre .city, tale IP code) ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON - RESIDENTIAL VALUE. VALUE VALUE VALUE Land not exceeding 1 (one) acre immediately (1) surrounding residential improvements. - Otherland (2) Total land (line 1 plus line 2) (3) Dwelling (4) Residential improvements Garage (5) Other improvements (6) 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 Assesor Date signed complete. Verifying action - Signature of Auditor Date signed 9 STANDARD DEDUCTION ALLOWANCE 19_ Pay 19 Lesser of 1/2 Homestead $ Valuation or 52,000 Signature of Auditor I Date ed/� yM,._, V L— ©�