Homestead_Tooley (2) tieCLAIM FOR HOMESTEAD PROPERTY TAX YEAR
4 STANDARD /SUPPLEMENTAL DEDUCTION FORM
ir
State Fonn 5473(R13/12-09) HC 10
,� Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. ! ( 2. ;Ai
- n - CERTIFICATION STATEMENT - .
I(We) 1_ i 11111' = certify that ICrTwwe °� ied as my(our)principal
place of residence or am(are)buying the following described real property for whi - Homestead Property Tax a-gr da4 Dedt an is hereby claimed
under contract on the date this application is filed, (date of filing). I(We):
El Own ❑ Mn(are)buying under recorded contract
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation GIBSON COUNTY AUDITOR
❑ 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.
pig mat:: n.r -=f+r-..c 4. ° - ft a � CLAIMANTiSTINFO_RMATI.ON= _ IT _ _
.L ac`s_.-
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
.,:_i r P,ROPERTcY.OESCRIPTION._- s - #,.ir_.' . l
County Township p �1Taxing dis 'ct(city,town,township) `'�i_`-�).�!/n - -
Parcel number L 1 description a.o A ? � I Is the property in question:
NW Nai /2_..2-4) ❑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 surrounds that structure is used to produce income,describe the use and portion
of the properly utilized to produce income.
a(a /a -/a -boo- OO/. 7 a.o -.o o y .
•
ems,.- -._, _PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES', y-17_-:2 , ._ - -
- �.:. -
County Township County I Township
I hereby certify the above statements are true,correct and complete. ignature o •• . 1
Address(number and street,city state,and ZIP code) - .
2I b- N So g ' :"-fc-rt<v Z^/ 44 7& 70
ASSESSED VALUE HOMESTEAD I NON-RESIDENTIAL
ASSESSOR USE ONLY TRUE TAX-VALUE
- - - - z :_ -1 s4.ax3- -i - ."AT 100703E1TV.- - vYALUE::. .- - VALUE 4
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)
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-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(12)of the assessed value of the mobile home or manufactured home.
Signature of Auditor '
A......n.LLcAd Date signed(month,day,year)