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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R71 545)
Prescribed by the Departmerd of Local Ckrveffunent rananoe
INSTRUCTIONS: See reverse side for filing instructions.
FORM
HC70 0 8
F.
z4-OK""atfl certify that on I st day of March N)_
40o /�Ivt aimed:
'a) occi.ipied as our principal pte�m of residence th f1k Wn6 described real property for which , Homestead It, 44'd
I (We) owned ❑ Are buying under contract V- GIBSON COUNTY 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
CONTRACT RECORDED#JiY'?i.?<
U hryng on contract Fee Simple owners name
Recorder's office where contract is recorded Record number Page
��PROPERTYDESCRIP TION,�� -- -- - ---
lT g p
Caunry
tip
Tang distri �t Guy'
Comfy
Township
I hereby certify the above statements are true, correct and complete.
Parcel number
property
C=—
❑ Mobile Horne (I.C. 6-1.1-7)
If any portion of the residential struch" or the Land not exceeding one (1) am that inirrvarlibdety, surrounds thid S6ucture is used to produce oxxime, describe the use and portion
of the property utilboid to produce rxxxine.
dt,l -/9- &/- JO �0 00 - -a- 061
52ROPERTYOWNIED I3Y4CLWMANT,1N
WWXVVM
County
Township
Comfy
Township
I hereby certify the above statements are true, correct and complete.
Signature of Auditor
street dry, V
C=—
, 0 '1V 11k OU �i'
i TRUErTAXPk,?, W
ASSESSED VALUE
Ko
-'H(
r§WX
NW - K M 7-, N4ESIDENTI L W �4
)
Land not exceeding I (one) am immediately
surrounding residential improvements.
Signature of Auditor
Date signed
Other land
(2)
. . . . . . . . . . I
Total land (fine I plus rare 2)
(3)
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Dwe lling
(4)
%
Garage
(6)
A wt sp 'Wr
Other improvements
(6)
Total mproverreants (rme 4 ffiriough One 6)
(7)
Trial value (Ana 3 phis One 7)
(8)
I hereby certify the above is true, comact, and
complete.
Sigrat o of Ascessor
Date signed
VanlyuV action - Signature of Auditor
Date signed
40 DARDDIEDUCTIOWALLowmm�
20 _ Pay 20_
Lesser of 12 Homestead
IS
Valuation or $35,000
Signature of Auditor
Date signed