Homestead_Hornby (2) "a 1 CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
/ M
4 STANDARD /SUPPLEMENTAL DEDUCTION H FORM
i' State Form 5473(R13/12-09)
Prescribed by the Department of Local Government Finance I // �1 --
INSTRUCTIONS:See reverse side for filing instructions. 67 l / g A - 3 5 t0
- CERTIFICATION STATEMENT _ _<-- . =t.
I(We) .. �6YLJ railI/L ;._ i. certify that I( .11.1! pi le as •. '.0 ,'pal
place of r: idence or am(are)buying the followin.r:escribed real property for which a Homestead Property Tax Sta •- d s - -:" Imed
under contract on the date this application is filed, (date of filing). I(We):
O Own El Am (are)buying under recorded contract OCT 2 8 2013
❑ 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 res'l
❑ Am (are) the shareholder, partner or member of the entity that owns the property. ii GIBSON COUNTY AUDITOR
TAT, _ i =;. .•4_ r . . i't aCL'AIMANTWFORMATION=�._ e... .,�, ':;-:-1.-a.:‘,.4.: . , . -' - ,
• ... .__
If buying on contract,Fee Simple owner's name i
Recorder's office where contract is recorded Record number Page
- 'P,ROPERTY.DESCRIPTION;: , , `Tad; °-_1-- - - - v
County Township Taxing district(city,town,township)
Parcel number Legal description Is the property in question:I
` -e I /7 ❑Real property '❑ Annually assessed mobile home(IC 6-L1-7)
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.
2" 10 - 13 -17 - 30 3 - 000- {4.55- a03
PROPERTYOWNEDBY CLAIMANTINOTHERL'OUNTIES'- ,_ Y, _C
County Township County 1 Township
Signature of claimapi fi I
I hereby certify the above statements are true,correct and complete. V/!)hIW,�V�p11,V)7
\Imr
Address(number and street,city,state and ZIP code) '
X 303 N, Cross Si. _ _ _
. • TRUE TAx•VALUE
,I. I ASSESSED
T,100%OF.•TTVE I HOMESTEAD -I NON• VALUE
NTIAL
ASSESSOR USE ONLY
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 I Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor I 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.
/ Signe t a Date signed(month,day,year)