HomeMy WebLinkAboutHomestead_Chamberlain (4) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
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STANDARD / SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R13/iz�g) HC10
�,.,. Y' Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. ,°• - CERTIFICATION STATEMENT - - - - •
I(We) f1//W� _ _��...�i certify tha(Ut*)5Ccul2013s my(our)principal
place of re idence or am(are)buying the following described real property for which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing). 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
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
_ ` c a.-. `!^-1: ,}_":.. QLAIMANT:S.INF R IYN- -a1s.4i$} <` +sip' _: 1727- ., -;P.0-A
7mant(lagaIn )ame t
Social Security number of claimant's spouse(last five digits) Driver's license/Identification/Other number State
of claimant's spouse(last five digits)
_ - . ' -577: _-I- - CONTRACT_RECORDED. .t+_ 42 �r =It .�i --.-
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number Page
-,,.. - . - - '._ _ PROP„ERTYDESCRIPTioi,r--4, °' `-_. :7-1-.;-.1' - '�
County Township Taxing dis city,town,to ship)
Parcel number Legal description I Is the property in question:
I Cee,'4.9.e-�r-- O.t _cee-C 4 P TI ❑Real property ❑ Annually assessed mobile home(IC 6.1.1-7)
f any portion of the residential structure or the land not 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.
c2. to - oy- a-Lf 303 - 000. ,- dr8 - o x6
. -__ 41,_„.., PROPERTY OWNED BY CLAIMANT IN OTHERLCOUNTIES ._ _. -'x -_ I. .
County 1 Township County Township
/I hereby certify the above statements are true,correct and complete. to of claim-
t /
X Address(number and street,city,state,and ZIP cod
//V. e •2 - e ; Tcfr La' 4/7664
-ASSESSOR USE ONLY TRUE TAX VALUE - ASSESSED-VALUE HOMESTEAD NON-RESIDENTIAL
-- - 1.__ t_I'= -4 _a_ ..s.. aAL100%.OF'TTVc _ VALUE.. - _ - - VALUE s.
Land not exceeding 1 (one)acre immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Annually Dwelling (4)
Assessed Mobile I 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)
.STAN-. . — DUCTION 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 t,(�
one-half(1/2)of the assessed value of the mobile home or manufactured home. 1
Signature (Auditor - Date signed(month,day,year)
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