Homestead_Will (6) /
°'4i CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
e4_. . t STANDARD / SUPPLEMENTAL DEDUCTION FORM
- State Form 5473(R13/12-09)
HC10
St"),-4.--, Prescribed by the Department of Local Government Finance
9 #
INSTRUCTIONS:See reverse side for filin instructions.
y. CERTIFICATION STATEMENT -
I(We) .Mtri' A _ ': _ certifyithat I -)o t ed ash• o:11,) cipal
place of residence .ram(are)buying the following described real property for which a Homestead Property Tax Stan.ar. ie.uc o ' - A. claimed
and contract on the date this application is filed,
(date of filing). I(We): DEC 2 '7 Own ❑ Am(are)buying under recorded contract 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 re
❑ Am (are)the shareholder, partner or member of the entity that owns the property. GIBSON COUNTY AUDITOR
- - _'__ a -.ia. t- n C.''.,a.- --^,,. CCAIMANT;S.INF_ORMATION_..-Zi- .76.. • ... - ,:i_ ��_' -_�s.'�,iftErn
Name of imam(legal name
a e2.,: • ._., _ :CONTRACT RECORDED _,e , - _ -:
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
1
:-: - .PROPERTY DESCRIPTION _ _ _, - - - ,
County Township Taxing district(city,town,township)
Parcel number Legal 3 c.,� Is the description P property in question: I
Pr Sw 31-3 —1 Q ❑Real property ❑ Annually assessed mobile home(lC 6-l.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.
2& .
- f9- 3r- 30o - coo . ; srY- o09
. ,
- PRPE
ORT�YOWNEDBY CLAIMANT IN OTHERCOUNTIE$_, —__ _
County 1 Township County Township 4.
I hereby certify the above statements are true,correct and complete.
gnature of claimant I . `
Address(number and street,city,state,and ZIP code) / I
A , • _ . , sr# A V .�S ' • .DT —TA/ y '6 •
ASSESSOR USE ONLY •
.i-. I TRUE TAX VALUE aAAT E00%OF<TTVEI HOVALUFAD I NON- VALUENTIAL
Land 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)
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 Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor ( Date signed(month,day,year)
- _ - . _ - ._ _ _ __ _
- _ ._. STANDARD DEDU_CTION 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(1/2)of the assessed value of the mobile home or manufactured home.
Signature of Auditor ' ` / . I Date signed(month,day,year)
u