HomeMy WebLinkAboutHomestead_MeriwetherCLAIM FOR HOMESTEAD PROPERTY TAX
!)° CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5-92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM
HC10
YEAR
CERTIFICATION STATEMENT
I e -certify that d1 s a ,'y�5��!dre 1
I (We) occ ied as our principal place of residence the following described real property for which a Homestead Prope ,Rhea y tr�re6y ' 'e&
❑ I (We) owned ❑ Are buying under contract -'o M� �� c4000 -
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or I buying un er a contract.
CONTRACT RECORDED � .
It buying on contract, Fee Simple owner's name 1-4 GIBSON COUNTY AUDIT•O^ 1
Recorder's off" where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township)
number
_
Legal description
C
If arty portion oI the residen structure or the land not exceeding one (1 acre that immediately surrounds that cture is used to produce income, describe the use and portion of
the proper; utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
county
Township
County
Township
ereby certify the above statements are true, correct and complete.
i ature I claimant
Address (number and street. city, state. ZIP code)
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, Correct, and
complete.
Signature of Assesor
Date signed
Verifying action - Signature of Auditor
t!r:
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
Valuation or S2,000
$
Signature of Auditor 1
Date signed
O_O