Homestead_Ritter (2) CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
STANDARD /SUPPLEMENTAL DEDUCTION
6'° State Form 5473(R13/12-09) HC10
�, 7 Prescribed by the Department of Local Government Finance IL r.
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INSTRUCTIONS:See reverse side for filing instructions.
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I(We) certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real property for which a Homestead Property Tax dard du . .s-Mereby claimed
under contract on the date this application is filed, (date of filing). I(We):
❑ Own GIBSON COUNTY AUDITOR
❑ 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.
.
If buying on contract,Fee Simple owner's name _
Recorders office where contract is recorded Record number Page
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_ - PROPERTY DESCRIPTION -
County r1 Township Taxing district(city,town,towns ip)
4 4,11
Pa I number Legal description Is the properly in question:
?6-///g-2�— �'s / pal property ❑ Annually a . bile home(IC 6-1.1-7)
If 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.
- - _ ,PROPERTtYOWNED,BYCLAIMANT-IN OTHER,000NTIES.: -. - - _ _ .
•County Township County Township .,
I hereby certify the above statements are true,correct and complete. ignabtre o da`roam -
Address(number and street,city,state,and ZIP code
Ai ( 7 5 o)d sic' 65 -owe1/43ulIIr . .n4%111746,
o ASSESSOR USE ONLY _I TRUE TAX VALUE ASSESSED OF TTVE I HO VALUE D _ I NON- VALUENTIAL
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 I Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
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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 properly may not exceed
one- If(112)of the assessed valu-of the mobile ho e or manufactured home.
Signal r: . Auditor Date sictror2el.ye