Homestead_Richeson (3)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT/STANDARD DEDUCTION "C10
State Form 5473 (8715 -M Y4 4
Prescribed by the Department of Local Government Finance, 1E
INSTRUCTIONS., See reverse side for filing Instructions.
I (we) certify that on the 1 st dgy6�irarch, 20
I (we) o0cupiea:!�Urftppall place of residence the following described real property for which a Homestead Property T��Iit in " Maimed:
5101 (We) owned El Are buying under contract GIBSON COUNTY I
Wave 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.
5 CONTRACT,-RE60RDEW*
It buying on con"cl. Fee Simple owners name
Recorders afka where conb c! is recorded Retard number Page
;OR rt4MOM� M
PkOPERTY,61ESCRIPTIOW,
County
7cwnship
Sr ne of clairnard
Taxing district (city, fown, township)
Parcel number
-027
Legal description
51
Is the property in question: 3:T
1. W property Mobil. He. (LC. 61.1 -7)
Marty
of Z portion of the residential structure or the land not exceeding one (1) acni
property utilized to produce income.
that irnffmKiaWty suffounds that s& uchre is used to produce income, describe the use and portion
A --W -1]0 -� 'Wt� k� k- TrIES' `Z M
d09'WW49 040".W." Q', T-'6, -;-PROPERTYOWNED BYCLOUMANTKOTHER'COUN �Ki,
County Township
County Township
I hereby certify the above statements are true, correct and complete.
Sr ne of clairnard
W07ar and streek crIX state. ZIP code)
15-7 ocu�
-. �
-, -?Y . . !,tN 2,
USE
Vi".TRUErTAXP'N�'It-
:j�kiHONIJIESTEADvpr'
"NONIRESIDENitA�-S WAI-
mu NL- " --.
7, "W!Wn K" , , � - -1 6 �;'
-. �
-, -?Y . . !,tN 2,
0 Z
Data signed
' '
Land not exceeding I (am) acre immediately
VVI
sumpunding residential improvements.
(1)
Other land
(2)
Tdal land (Ilne 1 plus [no 2)
(3)
Dwelling
(4)
N CC
Zql'
Residential improvements or Annually
Garage
Assessed Mobile I Mandan ured Flome
(5)
Other improvements
(6)
W -11
'4
Tdal improvements (fine 4 through line 6)
(7)
Trial value (Iffm 3 plus &* 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
signed
complete.
Varr" action - SV*Wm of Auditor
Date signed
V%'o STAN D ARD` D ED U C TI 0 N AL C OWAN CE
MW 2&a- Pay 20 g7c
Lesser of 12 Homestead
Valuation or 535,000
$
Sq,stLae 01 AU&W
Data signed