Homestead_Logestan CLAIM FOR HOMESTEAD PROPERTY TAX
�1 STANDARD/SUPPLEMENTAL DEDUCTION FORM
(t: HC10
YEAR
!' :'',.� / State Form 5473(R13/12-09)
% , / Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
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mr* ,,, ;ii±+.e - • � � ,; CERTIFICATION,STATEMENT ._ -r " .— v.f: . ..--t. v �", ._
I(We) ��.A..._._ � •L�. .,� certify that I( - �. ,.ipl�as rr�(our�pri...pal
place of residence or a i, are)buying the .flowing described real property for which a Homestead Property Tax Sta :. . Deducao is hereby claimed
under contract on the d-te this application is filed, (date of filing). I(We): MAY o 1 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 resid r
❑ Am(are)the shareholder, partner or member of the entity that owns the property. GIBSON COUNTY AUDITOR
rX-i.at &,r h i,S-a. r giikk CLIAIMANTpSIINFsORMATION 1.1k'n i '. T. ,2it 'a#'ia aart aA-_SFSi
Yi�'s;.��n:��=s . ��i>ar�r,�-= }� CONTRAC�RECORDED af5�,„ri��i��t�'u,,_->�,t-.>'� e� �:_y9...a.,.-.s.?,�`: y>�
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number Page
:yeayr..X�ie•rn�=c,..as?-..,s,ta�.��>berg°1.;`��'�'°-PROPR_TVDESCRIP,,TION Sdeeifit,^l:".° a s5
County Township Taxing trid(city,town,township)
Parcel number Legal desaiption C/.`/I Is ththeJ•property in question.
s/ Je a too O� J Zi 4--c'I❑Real property Annually assessed mobile home(IC 6-7.7-7)
If any portion of the residential structure or the tlandd 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.
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Y:fiata A" ?a,,a {_,'v xPROPOffirecWNED B IrAImista iIN•riTTHERtCOUNTIESk -47 11—S_ .liet'es .rg4I ii-.t
County Township County Township
I hereby certify the above statements are true,correct and complete.
Signature,yotff claimant
Address(number and• --I,dfy,state,and ZIP code
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vE+rs ° 'szcx A- -"' a'na Xfi'x;'s'r*,:air� ' ravi--° A ESSEDVALUE�fiziaSTEADC. NONRESIDENTapitict
arE`e �` ASSESSOR 11SEONLDs i .>,ismu TAX VAUE• j( ` a .a.s�r;+i �--
"�'yz4 �c?�C...,a�.a.�r,�: r,,..=.w�,.0 -yy'i,:�.�Ip�y. -a�'I�ATa100°/OF TTV.$I'�'�t`3VAL•l1Ei..t r �.� .�uVALUE e-
Land not exceeding 1(one)acre Immediately t.is .T r F
surrounding residential improvements. (1) x
r y
Other land (2) '` ?.�..-.'_ _,
Total land(line 1 plus line 2) (3)
Dwelling (4) '---?.r. >: '-
Residential improvements or Annually : -�
AssessedMobileIManufacturedHome - `�
Garage 5 °i ` 'a'�'' ��,1. ,%._
i.f J#} ::
Other Improvements (6) '_
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus 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)
.. e ;„1.- ? t-°-' ¢•r•*z' ` =m tech .3 L+Yk+alSTANDARD,_. L—RI - `" ''a` ti wee ziirWl eAtitA
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 toe manufactured home that is not assessed as real properly may not exceed
one-hall(12)of the assessed value of the mobile home or manufactured home.
Sgratu of Auditor •
i/ie7� Date signed(month,day,year)