Homestead_Kidwell CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
-4-rt-i4 STANDARD/SUPPLEMENTAL DEDUCTION FORM
\ State Fomr 5473(R13/12-09) HC10
,'j Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
. � �' a 11 4) N�_ ii CERTIFICATION STATEMENT - -_
I(We) �7JW� JIMMIES_S ., cerU 4J4 as my(our)principal
place of residence or a I(are)buying the following described real property for which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the date this application is filed,_ (date of filing). I(We): NOV 1 2 2013
❑ Own ❑ Am(are)buying under recorded contract
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation If
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualifie+'1t�' �1tr4 J�
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
GIBSO i i1 • • 1ul t
-ti _ 7-" ;jEAIMANT SNFORMATION .`r 'H' t E-a.?d ' .; � ,
" -
If buying on contract.Fee Simple owner's name
Recorder's office where contract is recorded I Record number Page
- - - PROPERTY DESCRIPTION - - -
County �l , . Township Taxing district(city,town,fownshi l / I ' 1
P el m r Legal description Is the property in question: I
- ?i eal property I Annually assessed mobile h e(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounA7s�th'at structure is used to produce income,describe the use and portion
of the property utilized to produce income. I
_Y`- 'F PROPERTY OWNED By CLAIMANT INOTHER COUNTIES*,e.,-- _- -,-, .;_T -, •_
County Township County I Township
I hereby certify the above statements are true,correct and complete. Si ature of claimant
Address(number and street,city,state,and ZIP code) ( 7" I
. I - I
�'r ASSESSED*VALUE HOMESTEAD NON-RESIDENTIAL
ASSESSOR USE ONLY TRUE TAX VALUE -
�T r. TRUE :n.. ATw100%OETI - -:,:r-VALUE- -- _- .:VALUE _'ta, -
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) I
Other improvements (6)
Total improvements(line 4 through line 6) (7) I
Total value (line 3 plus 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 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
on aft(12)of the assessed}'°foe of the home or manufactured home. .
Signs ur of Auditor I _ Date signed(month,day,year)
f III.