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CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
V V STANDARD DEDUCTION State Form 5673 (R8I7 -07)
Prescribed by the Department of Loral Government Finance
INSTRUCTIONS: See reverse aide for filing instructions. 3-R-0-7
CERTIFICATION STATEIkINIT
I (We) certify that orLtye�1 st day of March, 20
I (We) occupied as our prinapal place of residence following described real property for which a Homestead Propertfrav, a Fby daimed
gI (We) owned ❑ Are buying under contract GIBSON COUNTY AUDITOR
G 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.
CONTRACTRECORDED
It ctMng on contract, Free Simple owner's name
Recorder's office where contract is recorded Record number Page
County
Parcel number
If any portionq/ (he residential structure or the WrM not exceeding one (1) acre that imm�atey surrounds that
of the props axed to produce income.
dZ - /51-/f &0V e)00 S?1Y aa7
County
Township
I hereby certify the above statements are true, correct and complete.
al property ❑ Mobile Home (/C 61.1 -7)
is used to produce income, describe the use and portion
r I II`
+ress nu rand street, city, fe, en ZIP coda) ,r�
�d(o SnIA>'h MrAi0 �f.. nakiaa C14-t/,-TN. L-1?i (
ASSESSOR USE ONLY
[TRUE TAX VALUE
20 _ pay 20 _ 45.000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestete ad d Valuati on
.
or 43,000 for 2009 pay 2010 40,000 payable after 2012
AT 100% OF TTV .1
VALUE
VALUE
Land not exceeding 1 (one) acre intrnediately,
surrounding residential improvements.
(1)
t., •'.., ..:,;r e;.; .. =w;': ;,_r.._'T >;�.' ?7.
Other land
(2)
Total land (lime 1 plus line 2)
(3)
Residential improvements or Annually
Dwelling
(4)
"` •'".''�.rr_'Q;:,r,. _.,K'�`.,F. .r:'
Assessed Mobile I Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus fine 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed (month. day. year)
complete.
Vadtyirp action - Signature of Auditor
Date signed (month, day, year)
STANDARD DEDUCTION
20 _ pay 20 _ 45.000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestete ad d Valuati on
S
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor
Date signed (month, day- year)