Homestead_Schmidt "'", CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
,s._- { STANDARD /SUPPLEMENTAL DEDUCTION FORM
State Fomr 5473(R13/12-09) HC10
,�1 Prescribed by the Department of Local Government Finance `� jam'
INSTRUCTIONS:See reverse side for filing instructions.
F �:
// 1.1-.4 Ail r✓/ cej/ (CERTIFICATION SS-iATEMENT -
I(We) -y it ivr.sre,d m7 certify that I we)occupied as my(our)principal
place of residence h am(are)buying the following described real property for which a Homestead Prop Tax S nd ction is hereby claimed
under contract on the date this application is filed, (date of filing). I(We •
❑ Own ❑ Am(are)buying under recorded contract GIBSON COUNTY AUDITOR
❑ 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 residence trust
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
r-•:'4 r_ -----'1:" >;a..-77: Uzi `. � CLAIMAN ii,010ORMATION. .. _ "
` `
If buying on contract,Fee Simple owner's name
Recorders office where contract is recorded Record number Page
',Th. ,1
,.gxP,ROPERTY DESCRIPTION �-- n '. _ - _. _ , • s---.
AY Township Taxing district(city,town ir 1)(.-sryy) 1 _
411 lrJ
Ircp sup, -I g-aoi �., �„.3e' description a I Is the property in question:
�� r /i �\Jp�AU eel property ❑ Annually assessed mobile home(/C 61.1-7)
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.
_ -- - PROPERT'LOWNED BY CLAIMANT,IN;OTHER COUNTIES - :- £ :
County Township _County _ _ _„ -_ I Township -�- u gnature of certify the above statements are true,correct and complete. �� /
• S nature of aimant `
'.1
dress(number and street,city,state,and ZIP code) /Ldp
ASSESSOR USE ONLY -.TRUE TAX VALUE ASSESSED VALUE _HOMESTEAD:- NON=RESIDENTIAL r
L.-s ��yAT.100%;OFTTYo,I I.
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 pica line 7) (8)
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)
..
- c. y> - -^_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
al (1R)of the assessed value of the mobile home or manufactured home.
Sgn N f Audi or Date signed(month,day,year)