Homestead_CumberlandCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Slate Form 5473 (R8/7-07)
•� '� Proscribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
1 •u an
1 1 llr
G(BSON COUNTY AuutlLim
certify that on the 1st day of March, 20_
e occupied as our principal place of reside ce the following described real property for which a Homestead Property Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contract
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.
If buying on contract, Fee Simple owner's name
Parcel number L al description /U:&- Is the questton:
i yy
/LCR2lGi Real property ❑Mobile Home (IC 6 -/.1 -7)
If any portion of the residential structure or the land n exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
- �dS -703. Y86 - o °'"zo� gas o
Y? y e1 s - 000-
IV pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 44.000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation $
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor Date signed (month, day, year)
rr ..
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
,
Trial land (fine 1 plus line 2)
(3)
Residential improvements or Annually
Assessed Mobile I Manufactured Hone
Dwelling
(4)
- , -
Garage
(5)
"
,
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus fine 7)
(8)
I Hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed (month, day, year)
Verifying action - Signature of Auditor
Dale signed (month, day. year)
IV pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 44.000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation $
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor Date signed (month, day, year)