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HomeMy WebLinkAboutHomestead_Douglas (2) .4, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR d4._- STANDARD /SUPPLEMENTAL DEDUCTION FORM State Form 5473(R13/12-09) HC10 .‘�„, Prescribed by the Department of Local Government Finance INSTRUCTIONS:See reverse side for filing instructions. _ - - ' - - -CERTIFICATION STATEMENT - - I(We) s� a_ - !.. certi( at;(w( ;.ie, air our)principal place of residence or am(are)buying the followin:'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): JAN 2 7 2014 ❑ Own ❑ Am(are)buying under recorded contract ❑ 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 per st ❑ Am (are)the shareholder, partner or member of the entity that owns the property. GIBSON COUNTY AUDITOR 4 s -9:- . s r"7# .•- ` - - If buying on contract,Fee Simple owners name Recorders office where contract is recorded Record number Page c - .4 • -PROPERTY DESCRIPTION'' - ,7 . ` ... _-_-.7 --- . County Township 1 Taxing district y,town,township) I At Parcel number Legal Qdescription ) • Is the property in question: V ez description ❑Real property ❑ Annually assessed mobile home(IC 61.7-7) 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. j /S- /3 - 40 '/ - ooO. ! 7 4, -o.1.4 _ - E PROP.ERTYOWNED BY CLAIMANT IN OTHER;000NTIES ,- , --- County 1 Township County 1 Township I hereby certify the above statements are true,correct and complete. ignata of claimant / 1 of . . - ,,x.aa_I.: •'dress(number and street,cdy,state,and ZIP code) - • oo E• /C ' i 3 u err Fa'7— 84) RAJ cA .7-iv., 976 Li: al! s : A D V• HOM TAD NON-R ID NTIA U •NLY _ -� '1 v'„ :pT 100%:OF.TTV VALUE 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 pits 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 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 one-half(1/2)of the assessed value of the mobile home or manufactured home. Sig ture of Auditor , ex r r wC..Y"" Date signed(month,day,year)