Homestead_Peach V' CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
��7; STANDARD/SUPPLEMENTAL DEDUCTION HC
/r. ' State Fonn 5473(R13/12-09) S [ ;
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rr Prescribed by the Department of Local Government Finance
1
INSTRUCTIONS:See reverse side for firing instructions.
- s ra.. y 4' >w• lilt ya' e TIFICATIO1strSTATE ITiira hlaVA-nY a t.{. trii Ys
I(We) �ICAIdr !�' lI r��.� - , certify that I(we)occupied as my(our)principal
place of residence or am /)buying the following described real property for which a Homestead Property Tax Standard Dedp�t"on..is re at
under contract on the date this application is filed, (date of filing). I(We): j.WNML
%Own ❑ Am(are)buying under recorded contract GIBSON COUNTY AUDITOR
0 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 residence trust
Am(are)the shareholder, partner or member of the entity that owns the property.
n i ti ��ff 2 l T ....,. �4"'- R ITI∎I .l.•v+.a� ;ti J C +-+.>i+ '�ji,.atit..'Wt 'Xl a`Ea,i S�K t 1)u• 1'X::.
i.s�j.� �,,.�?.�ti` 5�'?}�v+-t�. 't.F�`� i�CLAIMANT�S�INFORMIiT,lON1i,.'�.�`i.,:"im6°t'y��a5 �.. a--.-. -.4 .H'.'�'.,-�n�...•=+SC^
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:C , :tikria LTI,: '.�1? u-k•�....`. .CONTRACT]1RECORordia3t'.'�'.:e fcT y.can' .ox.ro• ii."1.i4 .?-6.-. E
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded • Record number Page
i a itr--s2 ;=x - -z??F .'`H.7.zt :3e.i::'_'O. EROP,ER-Red 0ESCRIP,TION A t<_ 2s =ass ti ..i;_r.Viatt.,v"t�9,,t t::;-.
Car / v/`'' Township Ta?�' ntrrict(orN,f con,fown0�
i V-9 id/1 71'AL�N�
Pa ...v umber L •.I/ , ptizi.�o yJ 9 Is'the pprop��-erty in question
w ryf /!J '3- / qyT 1C°I proms' ❑ Annually assessed mobile home(IC 6-1.1-7)
If portion of tlo residential structure or the land not exceeding ono(1)acre that Immediately surroui cis that structure is used to produce income,desalbe the use and portion
of utilized to produce Income. /Q.50/1°
d6 Ao g 90/ 00/ 9/7- co
Fi c4pa tt„z P ROPERTyvg073Y�CLAIMAf�TaIN�OTHER000NTIES Yyen:r-:??- Y�,�,,.'?` ztivi e-ii-
County Township County - Township
Signature f claimant
I hereby certify the above statements are true,correct and complete. /r/
Address(number and • t,city state,cS ZIP aCOde) -c I N l ) /
Q J a e 104 cp 'V (Q
t..t ".5 ..t •t- 'ice t "x+2`rigfr: 1.'t•Y-t*e " -rfl ss,i1,ASSESSEDVALUE.(z±"HOMESTEAD t"`3rcr,�NON RESIDENTIALF':
` & SSESSOR USEyONLY„4,yt- e tll].3 1EeTAXrVA.LUEli�WATs100a0F,T<T,Viz{.F/ 44,VAL•UE?i--"�. 914.2.a +r'a VALUE F' ``3+ti�.`:
Land not exceeding 1(one)acre Immediately (1) -,'v
surrounding residential Improvements. - -
Other land (2)
Total land(line 1 plus line 2) (3)
Dwelling (4) s - *t n 1 _a a,�-xs Jc rt
'
1 Residential hnprovements or Annually - -
Assessed Mobile/Manufactured Home t-" +!"4 :t 5.. l cr- •.rx_
Garage (5)
Other improvements (6) =- --...%- -
Total improvements(line 4 through line 6) CO
Total value (line 3 plus line 7) (13)
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)
a.kgi,irgbr.\g ;y t;,S5-ri STANDARDyD D CTIONtALLOWANCE-A,&.r_a ai Sr`-+dzxrVi�u.FC!f<_-YR'
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(iR)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)