HomeMy WebLinkAboutHomestead_NobleC
I1!
L.
C
CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD /SUPPLEMENTAL DEDUCTION
S, State Form 5473 (R12 /6-M)
Prescribed by the Department of Local Government Fnmee
INSTRUCTIONS: See reverse side for filing instructions.
M�
FORM YEAR
10
DEC 2 2 2nno
-
CERTIFICATION STATEMENT.
s`
I (We) U ~
certify r1�w dd as my (our) principal
place of r si ence or am (are) buying the following described real property for which a Homestead Properrtyry Tax Stan Deduc�jton is hereby claimed
GIBSON COUNTY
under co ct on the date this application is filed,
pp (date of filing): AUDITOR
❑ I (We) awn ❑ Am (are) buying under recorded contract
❑ Am (are) entitled to occupy as a tenant - stockholder of a cooperative housing corporation
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
INFORMATION
Name of claim nt ( at name)
L
C+
Social Secot number at
Social Security number of claimant's spouse (last fm digits) Davels license I Idera fication I Other number Issuing State
of claimant's spouse (last fm digits)
CONTRACT ••r r
If buying on confmct, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
PROPERTY
County
Township Taxing distri (riry, town towrahip
` 0%
Parcel number
L desaiplion I e party in question:
Real property ❑ Annually assessed mobile home (IC 61.1 -7)
rtren of the residential structure or he land n e ceading one (1) acre that irp edj t s ds that structure is used h produce Income, describe the use and portion
p6t uafaed to produce income.
.7
PROPERTY OWNED BY
Caunry Township County Township
I hereby certify the above statements are true, correct and complete.
Sigriat o dalmant
Address (number and street, dry, state, a ZIP code)
Z11 S. nla, ` S1 62y bskkdi Li2ts39
ASSESS . OR USE ONLY TRUETAXVALUE r r NON-RESIOENTIAL
AT 100% OF TTV VALUE VALUE
Land not exceeding t (one) acre Immediately
(1) tom.
surrounding residential im rovements. - - - +?. •(- �+cs$... _k ..}'_: -.0 i
Other land
2`'=
Total land (line 1 plus line 2)
(3)
Residential improvements or Annually
Dwe g
(4)
Garage
vi.'yaiy'u5+`�:•':'
Assessed Mobile I Manufactured Home
(5)
it 's++.y
Other improvements
(6)?,
<'-';i1??: 'z
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct,
Signature of Assessor
Dare signed (month, day, year)
and complete.
Verifying action - Signature of mclitar
Dale signed (month. day, year)
STANDARD DEDUCTION
20 _ pay 20 Lesser of 60% of the assessed value of the homestead or $45,000
Notu hstanding any other provurion, the sum of he deductions provided in IC 61.1 -12 to a mobile Lame that is
5
not assessed as real property or to a manufactured home that is not assessed as mat property my not exceed
one -half (12) of me assessed value of the mobile home or manufactured home.
Signature of Auditor
Date signed (month, day. year)