HomeMy WebLinkAboutHomestead_IngramCLAIM FOR HOMESTEAD PROPERTYaAX
YEAR
CREDIT /STANDARD DEDUCTION - " Hcio-
t / Slate Form 5473 (R614 -03)
Prescribed r1 the Department of Local Govemmenr Finance FILED
INSTRUC BONS: SCe revcrsr. side /w liliny insfinx:finns
::CERVF.ICATION STAT61MENT'
I (We)ify that on the 1st day of March, 20_
(We) occupied as our principal place r idence the following described real property (or iG1 a Homestead Property Tic Cre }�'gj5preby claimed:
❑ 1 (We) owned ❑ Are b nder contract V
GIBSON COUNTY AUDITOR
I 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.
*- vF.`-, 3.- rs,.- ...�.7'!'$tr"t'��'.i,`t•3 `..r..r>r,._. ;: -....T CONTRACT- RECORDED r
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
...�. y I:Y., ..., 7FY,.S. -,u`N. .f,�.r- �.�.,-�'._:.:.� :`f P.ROP.ERTYIDESCRIP,TION'<, ji�zW..,
Township
Legal description
If any portion of the residential structure or the land not exceeding one (1) acre that
of the property utilized to produce income.
district
Is
[�Re�l property ❑ Mobile Home (I.C. 6. 1. 1-7)
wrrounds that s cture is used to produce income, describe the use and portion
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ASSESSOR USE ONLYf3.-r:
`TRUE TAX £
ASSESSEDVALUE
County
Tavnship
County
Township
hereby certify the above statements are We, correct and complete.
' na
dress (number and street, city, state. ZIP code) . '/
�oz s ojec3� o2 �1a0. 5-7A
D: iA-) 3
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ASSESSOR USE ONLYf3.-r:
`TRUE TAX £
ASSESSEDVALUE
1HOMESTEAD
�N
#-
3
2
T
t00Ye OFNTTV�y.
is VALUE..,?,
VALUENTIAL�. r.
c&�VALUE
_AT
r��: {. 2 .. ;+.'a.•u .
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3) .
Dwelling
(4)
��
'as it YYS•�`��'
Residential improvements or Annually
,r`ff
Assessed Mobile / Manufactured Home
Garage
k ,�r.,kt ♦ftr �.. �r
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 phs line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
verifying action - Signature of ywditor
Date signed
20 _ Pay 20 _
Lesser of 112 Homestead
Valuation or !f35.D00
5