HomeMy WebLinkAboutHomestead_Walters (5)CLAIM FOR HOMESTEAD PROPERTY TAX
.__ STANDARD/SUPPLEMENTALDEDUCTION
Shate Form Sd73 (R73 / 12-09)
� y� / Presaibed by the Deparlmenl of Lmal Govemment Finaxe
INSTRUCTIONS: See reverse side !or filing instrucfions.
fORM YEAR
HC10
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I(We1 � certify Ihat I(we) occuW as our) prindpal
place o( residence w am (are) buyirg th f lowing esaibed real property fw which a Homestead Property Tax Sfandaid� DeA�reby daimed
�Mer contraU on the date this application is filed, (date o�filing). I(We): �
Own �Am (are) buying under recorded contrect GIBSON COUNTY AUDITOR
Am (are) entitled to ocwpy as a tenant-stockholder of a coopefative housing corporation
❑ Have a benefidal interest in the wst or the right to ocwpy the property under ihe tertns of e qualified personal residence Wsl •
❑ Am (are) lhe shareholder, partner or member of the endty ihat owns the properry.
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Name ot da�mant ( e) ' (-`-�'��^J
$orAl Smri(y �
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Sodal
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If buyirg on contraU. Fee Simple ownefs iwne
rtemrders o�e,w�ere conuaa �s rem�aee ReCWd rwmErs Page
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Counry TownshiP Taxing ''(dty, town. foxnsh�D)
Tofi
Pa�cel number L I tl ' tion Is the party in Question:
3 aea� property ❑ n��uanr essassed monue twme uc se.,-n
If atry portion o/ Om residentlal structure or the tarid rwt ezceetling one (1) ave ihat immeEiatey wmou ds Ihat sW �iure is used W P�uce mcane, desaibe Me use aM pation
of Iha WopertY ulii'¢ed to protluce inoome.
-la-o�-�3, uoo. ��-oa�
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Counry 7ownship Counry 7oxTWilp
I hereby certify the ebove statements are We, correct and complete. � ot da'unant�
Address (numDes sLeet, dty, state, a� LPCOde)
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Land not esceeding 1(orre) acre ImmedWtey `a���" +�-r'' 6��y ; N`,r`�',
surround�n res�dentla� �m rovemenm. (�) �:'��� : �'*'�-• % � �; �= '�
� 2�'.=°�„t
Other land (2) ,e'��.y,�-'3i�'�','_
7otai land (line f plus line T) (3)
4
ResideMial Improvements orAnnually �IilnB (4) a1`i;; � d..L� -:����.���
Assesaed Mobile I ManufacWred Home �,c� .t av.1' ',a'�' �,F.��:.
Gara9e (5) -;� ;�€xi� � ��� `� y,".r�. y-
Otherlmprovemenu (6) s� �,7�"z'±����'i:
Total improwmeMS (llna 1 Mrough line � (!)
romi vawe ln�a s Pns n� n (a)
I hereby cerdfy the above Ia true, eorrect, �9^a�� oiwssessor Date si8nea (monM, daY.Y�A
and eomplete.
Verif�v�g adion - SigraNre W Pudibr �+� �re� (�N. �r. r��l
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20 _ pay 20 _ Lesser of 60% of Ne essessed value oi the homestead or $45,000
NoMiNStanding any oNer provisbn, fhe sum o1 fhe deduttiuns provided in IC 61.7-12 fo a moW7e honie fhat's $
naf assesse0 es reel pmperry ar to e menWactured Mme Met is na assessad as rcal propeny may not axceed
are-hatl (121 olMe acrossed velue o/(he moWle hortre w rrenWxNred home.
Sig�aNre of Nditor Date signed (month. daY. Y��)
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