Homestead_Greenwell El) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STAPPLEMENTAL DEDUCTION 1� \ FORM
Stat -09)Prescribed by the Department of Local Government Finance t i i Mr • _aw,
INSTRUCTIONS:See reverse side for filing instructions.
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-r,.4.,bsrSS. �... z. .:a.._a r..a Fa"�"�. :t...'''^r ERTIF.ICATION:STATEMENT¢.,:,;-...v�r�?- -L"E.+zsn-�f:'ca:A�v�t .. s. r.N... - . .,•
I(We) 'a ./�/_f n�,/ / . ,i �/ certify that I(we)occupied.3�.fy{3 pal
place of•.!C ence or a lhtre) • the following described real property for which a Homestead Property Tax Standard Deduction is here h ed
,er/ tract on the da - this lication is filed, (date of filing). I(We): GIBSON COUNTY AUDITOR
Own ❑ 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 .
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
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bz} _--�.-�.-... .. :a,.n. ..to}, r.....-.._itusx._..�..�.xtkC.CLAIMANT 51NF0 RMATION,�..;�+..,,:�.tvn.. tr,.?fir-F. �.`ir_� .. ky 4.+.;r�:>sZe:;, t':1
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Name of claimant's spouse(legal name)
Social Security number of claimants spouse(last five digits) Drivers license/Identification/Other number Issuing State
of claimant's spouse(last five digits)
raF t' - t -as�' ( ? _ T $14. `r +.. c-s.CONTRACT RECORDED�.. it`lfA...�-ii.irtaW S( e P>Sf ,is ...: u iS a._ . 'r.
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If buying on contract,Fee Simple owners name
Recorder's office where contract is recorded Record number Page
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Coon Township Taring 04° di-4 s /a(city, tun, wnshi
Parcel number Legal description Is the pertly in au Lion:
/ Real property ❑Annually assessed mobile home(IC 6-1.1-7)
If any pot14 of the residential structure or the land not exceeding one(1)acre that immediately su ds t structure is used to produce income,describe the use and portion
d the prrooppDD�Httyy'utilized to produce Income.
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County Township County Township
I hereby certify the above statements are true,correct and complete. Signature of anent
Sr
'dress(number and street,dtry�,state,and ZIP code) �.�. Un D
C I -.Q t t'I-e r /9 i2 fl 0 t t'4C'e-E )t2 ' .' _
r -:124' rAS SSOR USE.ONLY�r y �T'`matt`` TRUE TAX VALUE I ASSESSED VALUE.'Ii`'HOMESTEAD-cr)s yr 1 NON RESIDENTIALtr_;!�4
r,..t_ w• a .>. - , . ..°i-.a.:".•t'?ai,.- .: .45,.: EiT . E AT=100 ro OF.TTV,+;..tL .-VALUE t i , .,.:h'a .,r=.i.VAL'UE .�s is Y:
Land not exceeding 1(one)acre Immediately v zV,•"3.ih"W- - ,.Ic r'P- 'p.
surrounding residential improvements. (1) ;-; ' _ '' °---� .. ) X•
`'rte: ''' -2
Otherland (2) .4 ‘4 - -P-? ';`-._
Total land(line 1 plus line 2) (3)
-
Dwelling (4) T^ , rF +v i.Residential Improvements or Annually
Assessed Mobile/Manufactured Home Garage (5) sS , -, sF
Other Improvements (6) '�.3�„•5 '1
:y s 't•+.
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,sear)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
t
L1
/'ki:IPC4ss..Y{7J1'$3-4-•'' =`s. .+, .tYi'ious,'STANDARD'OEDUCTIONIALLOWANCET..tr`G- '*:i;``u�'i�u.>,.?,...3 [a+rti 7. h5'r':_.:r.t4 yY.�tu
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other provision,the sum of the deductions provided in IC 8-1.1-12 to a tontine home that is $
not assessed as real property or to a manufactured home that is not assessed as real property may not exceed
-
one-has(12)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)