Homestead_Epperson (3) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
a__ STANDARD / SUPPLEMENTAL DEDUCTION FORM
\l State Form 5473(R13/12-09) '} ' ' i
\; Prescribed by the Department of Local Government Finance - i • st
INSTRUCTIONS:See reverse side for filing instructions.
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n o ..--.--, CERTIFICATION STATEMENT ,
I(We) r' n--0--(1-40 ) • . • !/A.• certify that I(we)occupied as my(our)principal
place of residen - or am(are)buying the following described real property for which a Homestead Property Tax Standarq,L�duub7tlamod
under contract on the date this application is filed, (date of filing). I(We): GIBSON COUNTY AUDITOR
xi ❑ 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.
‘'_::4--, _ - r LAIMANT,SiNFORMATION=;_ :: ' - - "$"
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number 1 Page
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• .1
?�PROPERTY.DESCRIPTION_ - _,r
County Township Taxi g • W (city,to town ip)
//056 OC) Cli91/ d2/4
Parcel number L-j"scri`ptio�n 1/ Is the p petty in question:
O� 1.!(O- 3- // 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 sumo/des attsWi structure is used to produce income,describe the use and portion
of the property utilized to produce income. ,az
dl-/f JJ - oo -duo. 7V/-6°S'
.- • . . . PROPERTY;OWNEDBY CLAIMANT IN OTHER COUNTIES -. . _ _ _ _ ,
•
County Township County Township ti
Sign _ of claimant -
I hereby certify the above statements are true,correct and complete. 1
Address(number and street,city,state,and ZIP code) "C L V
/b ' AJ, -a.. 'ii _ i -..*AY i5_ri• � �'''7,. '
ASSESSOR USE ONLY • - - I TRUE TAX VALUE d ASSESSED E00°/o OF TTVE C HOVALUEAD I o NON- VALUE
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/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)