Homestead_Branham I
°'°a CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
i4_- STANDARD / SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R13/12-09) HCTO
' ,.„ Prescribed by the Department of Local Government Finance -' -"
I�Ip��"1,' 1
INSTRUCTIONS:See reverse side for filing instructions. .
� CERTIFICATION ICATION STATEMENT
I(We) :'it�la o- I_ , certify that I(+1. ., .J,I - y(our)principal
place of residence or am(are)buying the ollowing de-A which Homestead P
bed real property for wch a omestearoperty Tax Standard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing). I(We):
ii Own ❑ Am (are)buying under recorded contract GIBSON COUNTY AUDITOR
Am (are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation
I
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal r residence trust
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
- . . , ,. -,,r . =ft CL-AIMANTSfNFORMATION,t - .. r.
- - ' .CONTRACT RECORDED -
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number I Page
,I
PROPERTY DESCRIPTION
County Township I.t)j,Jaxing district(city,town,township)
.
Parcel number Legal description Is the property in question:
1 Ls,- '1A- 61 - L1 D r1-. n flD LL-1 -�'�� Weal property ❑ Annually assessed mobile home(IC fi 1.1-7)
-It any portion 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.
. -Y.....,r IA_..
- PROPERTyI'pOWNED,BY CLAIMANT IN OTHER COUNTIES - -
County - Township County I Township - .
I hereby certify the above statements are true,correct and complete. Sgna a daiman Shod t
Addres number and�st�We city,s to a .ZI-...-) `
`
ASSESSOR USE ONLY -'"TRUE TAX VALUE ASSESSED-VALUE I1bMESTEAD - thON-RESIDENTIAL
- _. _- _ - �. viTPX ._.:aAT',100 40FAT1/ , .VALUE .. VALUE - -
Land not exceeding 1(one)acre immediately
surrounding residential Improvements. (1)
Other land (2) I
Total land(line 1 plus line 2) (3)
Dwelling (4) 1 -
Residential improvements or Annually
Assessed Mobile/Manufactured Home Garage (5)
Other improvements (6) I
Total improvements(line 4 through line 6) (7) I
Total value (line 3 phs line 7) (8) I
I hereby certify the above Is true,correct, Signature of Assessor 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 S
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 Auditor _ �{"{-rte'
Sties r\.�{`}.J�3� -