HomeMy WebLinkAboutHomestead_Osborne (2)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
r State Form 5473 (R2I 5-92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM
HC10
YEAR
CERTIF N STATEMENT
I (We)
, hat jhjjjf March, 19_
I (We) occupied as our principal place of re idence the following
described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ I (We) owned ❑ Are buying under contract
JUL - 31 2000
❑ Have a beneficial interest in the entity that is liable for
the property taxes on the property and that owns the property or, -i ?'buying under a contract.
i I/
CONTRACT RECORDED GIBSON CO&TY AUDITOR
If buying on contract, Fee Simple owners name
-
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
Coon
Township
Taxing district (ci I wn, ownship)
P n tuber
Legal description
/'1 /f �/
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O
-00 C) 7
(ti/(JAIi
If any portion of the residential structure or the land not exceeding
one (1) acres that immediat surrounds at structure is used to produce income, describe the use and portion of
me property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
®tereby certify the above statements are true, correct
and complete.
Si natur aimant p,
U
Address (number and street, dry, state, ZIP code)
Ile I IS 5 '3aer '/ 10;00SiW I
IQ 47 34
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assesor
Date signed
complete.
verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
$
Valuation or $2,000
Sig a re of Audis
Date signed
3 / -LU