Homestead_PoeCLAIM FOR HOMESTEAD PROPERTY TAX
CREDMSTANDARD DEDUCTION
State Form 5473 (8715 -M
Presontied by the Department of Loral Goveavrent Fmnw
INSTRUCTIONS: See reverse side for filing instructions.
I (we) A'Uj ) ( ly. certify the i?�=r'*March, 20
1 (we) ;Z� A our principal place of residence the following described real property for which a Homestead Property Ta it kAenr claimed:
❑ I (ft) owned ❑ Are buying under contract GIBSONICOUNTY AUDITOR
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 buyini; on contract, Fee Simple ownses name
RecordWri office wbwo contract is recorded Record number Page
P ci cm 'no W
R PERTYMES Pj
County
Tirsvnship
Township
Tj to ' tawnstd
(01 Z A J ff ?L'
I hereby certify the above slatements are true, correct and complete.
Signatu
27;
Parcel nturbor
Leg dr1har, . p;p
propTty question:
SignatLire of kiditor
property
Wj Real Mobile Home (LC. 61.1_7)
It any n residedial stricture or the land not exceeding (1) acrif
of the incortre.
that immediately sunctinds that itruchffe is used to produce income, describe the use and portion
Z. PROPERTY.OWNED BY-.CLAJMANTJN-OTTIER
COUN11EZ'0.riK1
County
Township
County
Township
I hereby certify the above slatements are true, correct and complete.
Signatu
Address wand rawk oly. stats. ZIP wdo) I /
S1W Stee-1 Qgkl r xl --/-7/0(00
L- -A
+,f + -i.,°.�.,C.MANDARD�DEDUCTioN"ALLowANcE
•
ASSESSED VALUE
-4;V'MESjE
'75
-RESIDENTL
ON IA
. ....
Lesser of 12 Homestead
TS
'VA
'YWWALLIE,'
Land not exceeding I (one) acre immediately
Valuation or $35.000
SignatLire of kiditor
NEED", R,
surround' rV residential improvements.
Date signed
Other land
(2)
2
Trial land (fine I plus firre 2)
(3)
"improvements
Dwelling
(4)
q �WT
00, ,
ZY's
Residential or Annually
Garag e
�111ZM` A
Assessed Mobile I Manufactured Home
Other improvements
(6)
AWK
B 01
RE;-w
Tctad improvements (firte 4 dough fine 6)
(7)
Trial value (fine 3 plus Eno 7)
(8)
I hereby certify the above is true, correct, and
SignaWro of Assessor
Date signed
complete.
Verifying action - Signature of ALKIAW
Date signed
+,f + -i.,°.�.,C.MANDARD�DEDUCTioN"ALLowANcE
•
20_Pay2O_
Lesser of 12 Homestead
TS
Valuation or $35.000
SignatLire of kiditor
Date signed