Homestead_Kingsbury (2) �'�'�4 CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM
i� State Form 5473(R13/12-09) HC10
'---V? Prescribed by the Department of Local Government Finance •—
I
INSTRUCTIONS:See reverse side for filing instructions. t ,•�xv,•: - - _ '2) a . 7 „1'CERTIFICATION STATEMENT 4,_. _ • •I(We) Vf�Ol�� / _ w�w_ certify tha I • I -Riled as my(our)principal
place of residence or am(are)buying e follow' described re�.roperty for which a Homestead Property T Standard Ded chon is hereby claimed
and 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 ' 'i - 4• ....7, `�"."ci4.' .0 AIINAN iT S11NF,ORMATION - _ .yt`di, 4; �. . ,.°g
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
•p- s..e. n-. - j% e.sir',+:u -PROPERTYDESCRIFTION rr.14-'7,' •,'Jr.rT ' 1-f s.'r- '
County Township Taxin ct( ' ,t nn�,towwn\shii//p))/°I�jJ�
Parcel number L escri 'on I Is e p rty in question: C
� /i9„..2, e.,& .. (Pt 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 immedia e urrouA that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
16. 47.09_ /03- oo V,s90 - 0012 /. oai g )
re •13, p'*;, g;PROPERTY iOWNED.V'CUIIMANTIKO,THERiOUNTIES ..— --37 7,1 }--_ - ss'- €:
County Township County Township
I hereby certify the above statements are true,correct and complete. Signature of •an
-s n n streeeec city state,and ZIP code) !�
sii/ . /_ r — (reek SL_ f i.ncS/t . (./7G ?v
ASSESSOR USEONLY ° r. ? TRUE TA%VALUEk ASSESSED-VALUerHOMESTEAD� ThbN`RESIDENTIAL,
vo.4 '�ez'_4 '-' I'iAT$100%76E.A 11 ga[ivALUEk...l'.7s. ... -.....--VALUE .
yLand 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) I
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)
I - 7: STANDARD]DEDUCTION'ALLrOWANCEa `7" ''°�..;:
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 Date signed(month,day,year)
T7 R g I _ g I A