Homestead_Wagener a CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR-
-:% STANDARD I SUPPLEMENTAL DEDUCTION
s ue• State Form 5473(R12/6-09) HC70
S ;T.:-/ Prescribed by the Department of Local Government Finance
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® INSTRUCTIONS:See reverse side for filing instructions. ? i i t
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* ww,,CERTIFICATION STATEMENT
I(We) �l L 1QY �IK�. �.. L �L ,_certify that I( pi ore()yJ(our)principal
place of residence or am(are) 'rig the following described real p •perry for whi a Homestead Property Tax Stanc5415eduolion 1s e}hereby claimed
under contract on the date this application is filed, ( ate of filing): C, n _
❑ I(We)own ❑ Am(am)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation GIBSON COUNTY AUDITOR
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
If buying on contract,Fee Simple owners name
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Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION •
County Township Taxing district(city,mown,township)
® arcol number I description l Is the property in question:
6110 c03-1 b- coo- e0 a 4s-oa4 ❑Real property
❑ Annually assessed noble hone(C 61.1-7)
ny portion of the residential sWcture or the land not exceedii g one(1)ace that immediately surrounds that atnraure is used o produce Income,describe the use and portion
of the property utilized to produce income.
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PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Courtly Township County Township •
I hereby certify the above statements are true,correct and complete. Signature an
•••re .(number and sheet,city,state,end ZIP code)
153∎ E %moo s -Wc.,0bs \-k- s.J 4 9
I ASSESSED VALUE MESTEAD NON-RESIDENTIAL
ASSESSOR USE ONLY TRUE TAX VALUE I AT 100%OF TTV I HOVALUE VALUE
Land not exceeding 1 (one)acre Immediately 1 3jiar acv: s3Wa $ W
surrounding residential improvements. ( ) ni.•s�-Er >:;-grtra� 'f `R:1
Other lantl i ' + i. rt,
Total land(line 1 plus line 2) (3)
Residential improvements or Annually °� '�'r
Dwelling (4) :�" ` ,--.l s� .e ,'-t-a
Assessed Mobile/Manufactured Home Garage nsc y + ti ;
(5) t 7tr tat Stn-ro 'ath _:
" 'A• ni Other Ira rovements (6) Sa"3i.>{,?9.7s
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 Date signed(month,day,year)
and complete.
Verif ing action-Signature of Author Date signed(month,day,year)
STANDARD DEDUCTION ALLOWANCE
20 pay 20 •Lesser of 60%of the assessed value oflhe homestead or$45,000
Not ithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 o a mobile home that is $ -'
rot assessed es real property or to a manufactured home mat is rot assessed as real property may not exceed
one-ha f(1R)of the assessed value of the mobMe home ornu_nufactured home. - - - - - -
Signature of Auditor Date signed(month,day,year)
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