Homestead_France �•°'" CLAIM FOR HOMESTEAD PROPERTY TAX
e__. ' STANDARD /SUPPLEMENTAL DEDUCTION FORM YEAR
• • State Form 5473(R13/12-09) • r
.� ' Prescribed by the Department of Local Government Finance — =r°
INSTRUCTIONS:See reverse side for filing instructions. ,
•- _„ -- - EERTIFICATION STATEMENT. - .
I(We) '4' ,tOD *..-co \\S-11.-S1$e_02 ) certify that I(we occupied as m (our nndpal
place of residence or am(are)buying'fhe following described real property for which a Homestead Property Tax Stan. ereby claimed
under contract on the date this application is filed, (date of filing). I(We): GIBSON COUNTY AUDITOR
n ❑ Am(are)buying under recorded contract
m (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation
A n
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
❑ Am (are) the shareholder, partner or member of the entity that owns the property.
a -' ..—,- .�.,.n�. t&a -r jr_'PTIT EILAIMANTiSiINFORMATION=7 .:7_.__. _-_,. r3s -4 7:S "Airc f`s_
� s�:-.�i:..ka��.�.:_:ii�
If buying on contract,Fee Simple owner's name -•
Recorder's office where contract is recorded Record number Page
„,PROP.ERTY DESCRIPTION - ` ' y+; -'"
County Township Taxin district(city town,township)
Parcel number Legal description I I Ne rope in question:
Ab . 1$- 12. - 1 rya ,ct. to .4 -ba I s,1µTry,1)2 eal p perry ❑ 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 surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
z r ` - PROPERTVTOWNED BY CLAIMANT IN OTHER COUNTIES; ,
County Township County Township -'
I hereby certify the above statements are true,correct and complete. Si�g-/n��jure of claimant Uaimant n' - ' / `
f:ad-e.r-r 44r..& - L eh ;Q K.C c
Address(number and street,city state,and ZIP code)
/ • Go Se-, l_^_ LoOO Wes 4- 6 ewso:II< ZAl 47/o?
u ; • .TRUE TAX VALUE ASSESSED VALUE
ASSESSOR USE ONLY NON-RESIDENTIAL '
a. . I w.AT•1011%OE...T1Y:..I. HOMESTEAD
Land not not exceeding 1 (one)acre immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line 1 plus line 1) (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)
hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
I and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
-, STANDARD�DEDUCTIONNAALLOWANCE - - - _ _.__
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(1/1)of the assessed value of the mobile home or manufactured home. ..
Signature of tor Date signed(month,day,year) -