Homestead_Grubb- nCLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT /STANDARD DEDUCTION
` ' State Form 5073 (RS 17-07) i
. ,. Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instruc6'ons. F 8 2 3 2009 �1
CERTIFICAT10N
i (We) O'la c~ fy UaLTboie 1st day of March, 20
l pee,=cupied as our napal pace of residence the following described real property f r hick a �I ptb9't��d 'Propperty Tax Credit is hereby claimed:
tTWe) owned ❑ Are buying under contract SU
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 ••r
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
County
PROPERTY DESCRIPTION
Taxnahip Ta ing dish (city to , township)
�*
i /ice /L•G/CX / /Q'md
Parcel number
Legal descripti
Is the property in question:
I
( property ❑ Mobile Home (IC 6- 1.1 -7)
If any portion of the residential structure or the land not exceeding one (1) &a
of the property uUfized b produce income.
that immediately surrounds ft re is used to produce income, describe the use and portion
50
--oo 7
3.000.02
ASSESSOR USE ONLY
TRUE TAX VALUE
AT rr. OF
Land not exceeding 1 (one) acre immediately
`...
surrounding residential improvements.
(1)
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile / Manufactured Home
Garage
(5)
.
Other improvements
(6)
Total improvements (line 4 through fine 6)
(7)
Total value (line 3 plus fine 7)
(8)
1 hereby certify the above is true, toned. and
Signature of Assessor
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor /
Date signed (month, day. year)
STANDARD DEDUCTION ALLOWANCE
pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 000 for 2008 44, pay
Homestead Valuation pay 2009 41.000 for 2011 2012 $
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor Date signed (month, day, year)