Homestead_Rybachek CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD /SUPPLEMENTAL DEDUCTION HF FORM
ttor State Form 5473(R13/12-09)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. 8'1 l 3 83 - (p S c
CE_R'fIF.ICA�TION STATEMENT _ - ,
I(We) /f..t�_ ' • s.C4 Imo`- ' certify that I( pi:?,, a t ur ipal
place of residence o tam(are)buying the following described r:)1 property for which a Homestead Property Tax Stancard l e uc ion is ere.y .aimed
under contract on the date this application is filed, (date of filing). I(We): FEB 3 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 personal resi
❑ Am (are)the shareholder, partner or member of the entity that owns the property. GIBSON COUNTY AUDITOR
_S_t�aCLAIMANTiS INFORMATION: - ru
_ sue
It buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
;PROP,ERTY DESCRIPTION �.„Sr.; +. -' : L. -.
County Township Taxing district(city,town,township) -- -
Parcel number Legal ilescription Is the property in question:
( g tt't(,.∎ re '.87? ❑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 immed./tey surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
26 / ? - la - /ol - 000. 507- 0J. Z
- PROPERTY OWNEDBY CLAIMANT IN_OTHER COUNTIES „
a_ _ _
County Township County Township
I hereby certify the above statements are true,correct and complete. g re of cl ima
a)°� .
t/ Address(number and s,:-4 ci1};slab - ,ZIPCOde)
/� 1r.1 • 47 •lo
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE -HOMESTEAD° NON=RESIDENTIAL
._.. _-.c• n�;s...,.,a _ .._.•_. :za --se 1 A11100%:.OFsTTVS.Iw VALUE au+sln. -:.VALUE - _
Land not exceeding 1(one)acre immediately
surrounding residential improvements. (1)
Other land (2)
Total land(fine 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)
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)
;7,-STANDARD DEDUCTIONAL'L'OWANCE
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(112)of the assessed value of the mobile home or manufactured home.
Signet a of Auditor Date signed(month,day,year)