HomeMy WebLinkAboutHomestead_Payne (2) t. yr CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
STANDARD/ SUPPLEMENTAL DEDUCTION
cur: ',; State Form 5473(R13/12-09) _
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. iq�L�
.r,ra�c�'s�'. ';°r 1i.i'. '.z`t + .".:ti- ` ` CERTIFICATION STATEMENT""°��-"+`- -�z`3 ..3� .,,,T' i�r.•T x^# .1 bY4 4.:2�s.�a'
I(We) ntraw�L! certify that I(we • pied as my our)principal•
place of residence or am - e)/, g the followi ldescribed real property for which a Homestead Property Tax Stan•.•Z,¢:.-wynl; (ereby daimed
uunnddercontract ontheda.-
is -pplicationisfiled, (date of filing). I(We): GIBSON COUNTY AUDITOR
( Own ❑ Am(are)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation
p 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.
asz' �' r'�u-Sa 4C."_.v CLTAIMAN iSINFORMATiON, .&:" c- l •C'4` 4 1 _ c y, ,-- r j' t1"a
$
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?r�a -- %r -e. �•c trrgfi •r -CONTRACTjRECORDED e`` t{. 3�r?.nmsw ca''
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If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
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tt� aa3--rya;g,+�--+�3`°a��,� t,�ak-�f_t4� PROP,ERT�YyDESCRIPTIO�' rg*avn - �- +�
Court, / TowrshiD Taxing•-...,': .;: •; ,ai
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Parcel number Legal description U the rn question:
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 immediately su nds that structure is used to produce income,describe the use and portion
of the property utilized to produce Income.
do-/02—/ -- /a/0o/02/ - 9 5
�- """"T'^?`'� 541,-` ''`"•j'�*1 T FROPERTYOWNED f3Y'C AIMA�TrINrT�O,THER COUNTIES t i.g.:kio: '�:xfg„-i _--a.*oil∎i t
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County Township
I hereby certify the above statements are true,correct and complete. MI A '.1 1...
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• g€kr-,-'-x- ]. 95'a'f cf?1.-r?uj� �` xl�'l if frer rr�,:�3`.T.`ASSESSED VAI:UE'I`r+=''HOMESTEAD 5� *ANON RESIDENTIALfr7-,
Ltsa .- 4.S ESxrORTUSEONLYr1, -. * x t _,.,a 'T,44.ax iris UE.IliATi100%OF1.T.T,W. Vif ,VALUE' ?..e ae4X*4- -VALUE a 41 i
Land not exceeding 1(one)acre immediately (1) '-).*� > -"3
surrounding residential Improvements. ;
Other land (2) .; (-" 9 5
Total land(line 1 plus line 2) (3)
Dwelling (4)
Residential Improvements or Annually
Assessed Mobile I Manufactured Home
r -,7 ,-' s4 -,Garage (5) - :€ ` . •I'.
.
:r,-'I
Other improvements (6) - .
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
Signature of Assessor Date signed(month,
I hereby certify the above is true,correct, bey,year)
and complete.
Veilying action-Signature of Auditor Data signed(month,day,year)
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�'�...;�n"�,�:'�7'-a.' �� ' - 111:114r1-"_.k��'Sa"rs9 :i�'�s1:�STANDA ROIDED,UCTIONIALLOWANCEri�rd...�:�?�a� K•.?`u�v'ro.Y�...-..� �'S�vl,....-;rb�-.�_
20 pay 20 Lesser of 60%of the assessed value of the homestead or$15,000
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 mal property may not exceed
one-haft(1/2)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)