Homestead_Mulkey (2) t°' CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD /SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R13/12-09) HC10
, Prescdbed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
c _ � - .. CERTIFICATION STATEMENT 4 - " -
I(We) �� �� ...• S ie i. certify that. e) 'cc-pied ..y(: ncipal
place of residence or am(are)buying the following described re. ._.. for which a Homestead Property Tax da I • o. ' >�7A' •aimed
under contract on the date this application is filed, �• (date of filing). I(We):
H Own ❑ Am(are)buying under recorded contract JUN 4 2013
❑ 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 r ence
❑ Am (are)the shareholder, partner or member of the entity that owns the property. GIBSON COU. ■ : • • :
-'-17 •+: .- -_'..x�'f =� 41M MI ANT.'S1U ORMATION__. . _ rr'or_.: < _ '.' v :k .. ._t".. : - 9 s_..;
Name of aanl(I f me) , / '
Social Security number of claimant's spouse(last five digits) Driver's license/Identification/Other number Issuing State
of claimant's spouse(last five digits)
"
If buying on contract,Fee Simple owner's name
Recorders office where contract is recorded Record number Page
_ . - _ _ PROPERTY DESCRIPTION,- 7 . t::. 7, r -
County Township Taxin istrict(city,town,torte ship)
Parcel number • Leg desv/7pt�ion -1p I Is the property in question:
/t. se Cr/-,_/c? J7-�LI Real property ❑ Annually assessed mobile home(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrou is that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
a ,—/7-Z 9- /DoactO 35'(0 Oc /
• - +f- =-.^.PROPERTY OWNO)BY CLAIMANT IN OTHER;COUNTIES -, .1;-1. }; _ __" __ 'r ' i-`
Count' I Township County Township
I hereby certify the above statements are true,correct and complete. Signature of dp lima pt ,n,r
Address(number and street,city,state,and ZIP code) `�/
/04ee W. ?So S or.✓c,,st/) /lc r l• V7o&r
ASSESSOR_USE ONLY .I TRUE TAX VALUE IASSESSED VALUE' HOMESTEAD NON-RESIDENTIAL'— '
4 - s. = tAT-100°/OF=TTV- ,. VALUE-: VALUE -
Land not exceeding 1 (one)acre immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Dwelling (4)
Residential improvements or Annually
Assessed Mobile/Manufactured Home 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, Signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day.year)
- . - STANDARD-DEDUCTION ALLOWANCE • _
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 6-1.1-12 to a mobile home that is $
not assessed as real property or to a manufactured home that is not assessed as real property may not exceed
one-half(1/2)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)