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Homestead_Wright (4)�.., fi. _��. d`�1`, �:_���_ CLAIM FOR HOMESTEAD PROPERTY TAX STANDARD / SUPPLEMENTAL DEDUCTION State Form 5473 (R13 / 72-09) PracrsiMM M thw Mrurtmnnt nt 1 mal C,rnrmnmant finam» Fow� HC10 _ vi INSIRUCTIONS: See �everse slde lor fitirg ins6uctions. I(We) • ceAiry that I(we) ocpu� ap!gy�prindpal place ot res' nce a am (are) buying the fdlowing described real property for whi Homestead Property Tax Shandard DU ucdon� is hereby daimed � er on ihe date ihis applicatio� is filed, (date o�filing). I(We): C.'J.M �—�-.-y t \ �\ ❑ Am (are) buying under recordetl contrect V V ❑ Am (are) entllled to occupy as a tenant-stockholder of a cooperelive housing corporatlon GIBSON COUNTY AUDITOR ❑ Have a benefidal interest in the Wst or the rignt to ocwpy the property under the tertns o( a quaiified personal residence Wst . ❑ Am (are) the shareholder, partner or member of the entlty �hat owns ihe property. �. ., e o( da4nant (kgal narta) �ry �� Sorial Seariry numher of tlalmanCs spouse (/ast five d'g/ts) Orivefs Ocertae I IdrntiOption I 01her number IssWng State of tlaimanYs spausa (lest (rve digds) i � �-� � If buying on convact, Fee Simple avners rame Remrders otfice where ConUaG is 2corded Retord rwm6er Page ..�_ . � . � County TawnshiP Tav�g di,trid (dty. town� townshiD) I num q� Legal desaiption Is the propery in puestion: � ' 3 �V � • ao _O ❑ Real propeny ❑ Mnuairy essessed mohile homa (IC bf.7-7) It arry portirn ol the residenUal sWCture or ihe IarW nol exceedinp ona (1) aue that irrimed"ute�y surtounda ihat strudure is used W Produce ircome. deuribe Ue usa aM portion W tlie property utilkad N protlum Inmma. • � � a3-1-►� ... . . _ . . Coung' Tovmship County Township I hereby certify Ne ebove statements are We, correct and complete. signa f da'unant AdEress (number e� sheef, rify, state, erM;lP toda) y� ` Vv IV �O��v� • � � � • � �• � ��•, • Land not exceeding 1(orre) aere Immedlatety (�� '� F y`��'�"'�'`„x„t.� �""�t '. surroundin realdentiallm rovements. �—g'x- �'.= �flY x "�i h«: d.8� '�`Frvr,'.:, r. �_ �a:+, Other land �2� :J, c-�.? �f:'?�.2'%P= Tomi iana prrre , pms mre T �3� h:'�- i� , =2 �F`-� ``� � ResiderrtiallmprovementsorMnualy ����ng (4) �„� ,;y"�x.� �,,,y-,-r�,-q.;r Assesud Mobtle I Manufacwred Home r� ��`F �. yi��; €js jF�^- �. Garage ($) ._�-�=�.__•�`,._..,._..._:t:k.,_iF..�7�.� �..:x 1 f�r-`� i?a.'3"'�_ . Other Improvemenffi (C) # � ef $�" yy3es"`b;« Total improvements (Ilne I Nrough line � (7) Total value (line 7 p!(a Iine 7) (8) 1 hereby eerd/y the above is We, correct, �"a�re of ��Of �� �9�d (�th, dey yea� and wmplete. Vaify"ug action - Siryaeire of Autlitv � s9^� (^b^N. �Y• Y�A � • • � � � � • 20 pay 20 _ Lesser of 60% of the essessed value ot the homestead or $45,000 NoMilhstending anyWherprovision, (he s+im of Ne deductrons provkietl in IC 61.1-f2 ro a rtrobBe home Nat is � not essessed as'eel property w ro e menufactured home Nef is no( essessetl as rea/ proparty maY raf exceed one-Aatl (f2J ol Ne assessed ralue ol the mo6ile fartre ormenufectured home. SgnaLUe of Ndimr Date syned (month, tley, yeaQ . _____________-_ ��� v