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HomeMy WebLinkAboutHomestead_MarshallCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR CREDIT/STANDARD DEDUCTION HC10 State Form 5473 (R7 I 5-05) Prescribed by the Departinant at Lixal C3ovemrnerd Favnix, INSTRUCTIONS: See reverse side for Filing instructions. I (We) I-A-A-k -V /S— 'I- L-ViL J(/ KL�, U/"J&M I (We) occupied as our pfindpal place of residence the following described real Property for which a Homestead d1, 20 N claimed: I(We)owned ❑ Are buying under contract GIBSON COUNTY AUDITOR '.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 rift) 114, NTRA T5RECORDED co C 02W, 11 Wyinf; on ointrad. Fee Simple a~s name Reourder's office where contiact is recorded Record number Page 4 0 R ap E R T.Y.. o w N E 6: BK , c L At m A N ti i N i 0 T H E E R 'C 0 U ? f b E S f K, D VV F; �*QAAiN PkomnybEscmulok : 1 County County Township TwdN district (ally to 7zr!ht number and &MJ LL,TAI Parcei'm?r6er -103-0pal:�Sk)oa- Legal description I Ls the property in questo : PEeel property ❑ 4;kiH..(f.C.6-fJ.7) If arty portion of the residential struch" or the land not exceeding one (1) acre that knmediately surrounds that struchire is used to limiluce hoorni, describe the use and portion of the property utiUmd to produce irtooine. 4 0 R ap E R T.Y.. o w N E 6: BK , c L At m A N ti i N i 0 T H E E R 'C 0 U ? f b E S f K, D VV f4-�'Qa OM'! ' "WZ -So+N" A ' County Township County Township I hereby certify the above statements am true, correct and complete. Si ature number and &MJ LL,TAI /V qW0 Og 20 _ Pay 20 R, 7 D M ' NONAESIDENTLAJ15W 6, S ITM13147 jV E Land not exceeding I (one) acre invT*dab-* m'l RON- surrounding residential impnrvements- Other land (2) zig R I as Total land (line I plus Fne 2) (3) Dwelling R Residential improvements or Annually (4) Garage (5) pr: Assessed Mobile I Mantractured Home R4 Other improvements (6) TctW improvements (Ane 4 through fine 6) (7) Total value (fine 3 plusfine 7) (8) 1 hereby certify the above is true, correct, and complete. Signature of Assessor Date signed Verifying action - Signature of Auditor Date signed sTANDARDCDEDucTioN1ALLowANm 20 _ Pay 20 Lesser of 12 Homestead Valuation or $35,000 S ITM13147 OWNW1111