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^. CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
.
STANDARD /SUPPLEMENTAL DEDUCTION
S"' -- State Form 5473(R12/609) HC1 O•
Prescribed by the Department of Local Government Finance - -
INSTRUCTIONS:See reverse side for filing instructions. - FILED
I(We) • certify that pi my(our)principal
place of residence or am(are)buying the following described real property for which a Homestead Property Tax S dard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing):
7f I(We)own ❑ Am(are)buying under recorded contract GIBSON COUNTY AUDITOR •
❑ 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
CLAIMANT'S INFORMATION
'
If buying on contract,Fee Simple owners name .
Recorders office where contract is recorded Read number Page
PROPERTY DESCRIPTION
County \ Township Taring ' ct( town,township
P� , f/,/X/-/) x`10
Parcel number t�gal description �I Is perry in Question:
I'u/ /��//N/ � Real property ❑ Annually assessed mobile home(IC 61.1-7)not
of nyny xl of the re idepmtal sa�cture Ibe 1 exceeding one(1)acre that immediately su nds 7,3 osed to produce Income,aerate the use and portion
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES -
�( Country Township County //� Township •
I hereby certify the above statements are true,correct and complete.
Signature of claimant a/lytl/'
mass(number and street,c/ity:state,and ZIP code) f / %//�/(// •
/ P' •r r/u.nr, :c/e ' A.^�%/s/r Y7 &3 S
'V) ASSESSOR USE ONLY I TRUE TAX VALUE ASSESSED 00
AT 1 %OF TTVE I HOMESTEAD AD I NON VALUE•
Land not exceeding 1(one)acre immediately 1 r'&4 a1,7A la -tea
surrounding resitlential improvements. ( ) - 1:4..- + '<,-.xr, y r
Other land (2) kgistsiiticc4
Total land(line 1 plus line 2) (3)
Residential Improvements or Annually Dwelling (4) =.-t ' .�s`R s
tgcs4 Assessed Mobile I Manufactured Home Garage ¢� 'z.` r iv) -,�#"x
(5)
• 4ks.4-7&-v1a �' _ }A'.A .•.11 i Other Improvement (6) }t'YG.3 nb .:' --_ - -
Total Improvements(line 4 through line 6) (7) '4�,
Total value (line 3 plus line 7) (8)
( Signature of Assessor Date signed(month,day,year)
O I hereby certify the above is true,correct,
? and complete.
T Verifying action-Signature of Auditor Date signed(month,day,year)
a STANDARD DEDUCTION ALLOWANCE
N.` 20 pay 20 Lesser of 60%of the assrased value of the homestead or$45,000
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a monde home that Ls $
not assessed as real property or to a manufactured home that is not assessed as real properly may not exceed --
one-halt(1R)of the assessed value of the made home or manufactured home. l�
Signature of Auditor Date signed(month,day,year)