Homestead_HayesCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
., - _ CREDIT /STANDARD DEDUCTION HC10
State Forth 5473 (R8 17-07)
•� r•.. 1 Prescribed by the Department of Local Government Finance
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.
If buying on contract, Fee Simple owner's name
where contract is recorded I Record number I Page
Taxing district (city, town Mt& 0
/mel number '1 nnI 2 Legal description Is the property in question:
1 -JLJ -1 1-- plIDf- WL3(_� �ryeal Property ❑ Mobile H. (1C 61. 1-7)
"a portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to Produce income.
71 _ pay 20 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 44.000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation
w 43,000 for 2009 pay 2010 40,000 payable after 2012
rr
Land not exceedng 1 (one) acre immediately
surrounding residential improvements.
(1)
'• "- '::'. > -r,'.
Other land
(2)
Teal land (line 1 plus line 2)
(3)
Dwelling
(4)
- --
Residential improvements or Annually
-
Assessed Mobile I Manufactured Home
Garage
Other improvements
(6)
Total improvements (fine 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)
71 _ pay 20 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 44.000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation
w 43,000 for 2009 pay 2010 40,000 payable after 2012