Homestead_Davis (17) }_ CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
c`4 STANDARD/SUPPLEMENTAL DEDUCTION FORM
{" State Form 5473(R13/12-09)
`.. Prescribed by the Department of Local Government Finance C
INSTRUCTIONS:See reverse side for filing instructions. 8 1 t 8 'i $ - 2,5 q 3
`° CERTIFICATION STATEMENT d',14-.,. t SKK',y'1w ia7t Y;i.s,r,.r-.
I(We) //I r`s-'('�'� �•—.#tl-� _ certifythatl(we{... I :.s my l.. )p. .
place of • Bence or am(are)buying the following described real property for which a Homestead Property Tax Stand- '. D-.. a .teby . - S
under contract on the date this application is filed, (date of filing). I(We):
❑ Own ❑ Am(are)buying under recorded contract APR 2 4 2014
❑ 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 residedd6. .
❑ Am (are)the shareholder, partner or member of the entity that owns the property. GIBSON COUNTY AUDITOR
'•• ^".
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number Page
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t>ends'r:d,......x'�sla`�-'„'•'^v\;'i`.....���Lt'�'� ROPERTfYLDESCRIPTION � i�.i" �,a�._.� .:lvtX.k,' -3f°�"•'�{3� �.. _adR#Rt" ...`s:.�.r�
County Township Taxing district(city,town,township)
Parcel number Legal description 3. 5 A CH I the perry in•,-Lon
I SE N a.' 34_,a . 17 Real property ❑ Annr.i assessed mobile tome(1C 8-1.1-7)
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 utIl ed to produce income.
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x r "T,x,�yZ tri;EPROPERTAY EOWNEplp_ACLRAIMANTXIs40174RCOU NTIES_ at;; P S,?t -ii—gOC V4--,1!;t'
County Township County Township
I hereby certify the above statements are true,correct and complete. Signature of claims
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`(Address(number and street,city,state and ZIP code)) Al-
)(Address
0 7 0 l.J ( 000 o Writ C I r ' Al A 7 4 r �_
f�=°z—we�,'f 'P3ee•�' "s '' ` ` e'I' '`'mo fASSE55E DVALUEIY HOMESTEAD7`-.,tyr�'' %NONRESIDENTIAL ,'." q.
a' s f�1". ASKS S30RUSE ONLY� %;s t.� i TRl1ErT UE IwAT;1100%OF�T.TV,V, ;..:�4VALUE"d-tI% src 1VALUE < a;-:?=c_
Land not exceeding 1 (one)acre immediately 2 o �,
. '.
surrounding residential improvements. (1) - ' _' ' ._i -°"'
Other land (2)
Total land(line I plus line 2) (3)
Dwelling (4) , . i rr k .:57,:-;_-1-
Residential Improvements or Annually 3 ,_
Assessed Mobile I Manufactured Home ge (5) . , ^c. _. -:!2,- _ :
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus fine 7) (0)
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)
1 x � '' "+r��g:I "'S""`f $ ANDAI IE�UCTIONAlinicn ANCE�T -I '-`-� �4"c".3. ,,;, it u -r~'
.ci `h'sru.�:3esi. sf�-:X�' :�'S-•'St['^'°' " 1— i__Y...v... 1a.�.lW'�4=-� �'iici4e�^.>.�"f?s.a.R
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 properly may not exceed
one-hat/(12)of the assessed value of the mobile home or manufactured home.
Signs of Auditor i��J� - - Date signed(month,day,year)