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Homestead_Wilson (2) t"\ STANDARD/UPPLEMENTAL•DEDUCT ON FORM YEAR Cs;a} State Form 5473(R13 1 12-09) HC10 ` . Prescribed by the Department of Local Gwemment Finance • INSTRUCTIONS:See reverse side for filing instructions. n%d;-F 4"� ,�. .r>'3Y ` ,;"f:a �;���yr rirlFiC!{T10N STATEMENT•' A'� r t''Sca gA RitV'"tom` ;yy '., �t!:.. :��.:.r� -yc�•t5i+�xiu��� mv(39-A 1 6�?b.� .�,,,]� I(We) Sj5f . �•-' t.WAt.J2Mt certify that I(vl'ti iocel v'CV I4y(our)principal place of residence or a fare)buying the following described real property for which a Homestead Property Tax Standard Deduction is hereby claimed under contract on the da - this application is filed, (date of filing). I(We): /)r Own El Am(are)buying under recorded contract GIBSON COUNTY AUDITOR El 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. Mtart . tS,. s .-•r ei.aa.7174 MANT SjINFORMATIO∎Itt i ' e/4.1 -4554; C:Vet ..4lr rr&& If buying on contract,Fee Simple owners name Recorders office where contract is recorded Record number Page • -r"z "` 1+ r '` 'Pa;IWO.I,Eilli ESCRIPTIOsitic.2" t X._l :4WA2Y' '(d+'a'.1yt ,`�*�E„`i:;.: County tail a ' Township Taxing district(city;town,township)5 a$_ 1 trio -o o a.9 ay-0 r7 Parcel number Legal description Is e lCoperry in question: Real property Q 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 surroun that structure is used to produce income,describe the use and portion of the property utilized to produce Income. ?) a„... .,.�su - ut`Y'„y -�;A;;; _FROPERTY,LOWNED!BYjC I;AIMAnT.I NAT HEf2 651J NTIESey3/1?!itf•ti�„i. ..., a:a-x.:+�%iar - County Township County Township s I hereby certify the above statements are true,correct and complete. Sig .•• e • .i c1 �t ��/p y■ ! / C10- .../ lam,(t ji-',C--/ Address(nurr� i ,- „DID code) I , ' M1-'+� r SxV-t— Y-'�A "sr'i'111 H r=Fnr-11?"�C111."` '''L'67 TASSES9ED VALUE rifer argil'AD" Plat,rdoN�RESIDENTIAE i ' ' iy „_rASSESSORn USE natyt Onc £ �TRUESTAX+s A.L-E•,I�.AT5100:/o O�T�TV t�VAL`•l1Es�` .- �xa" VALUE s _Y`c+`•`.(l'° Land not exceeding 1(one)acre immediately (1) surrounding residential improvements. Other land (2) Total land(line 1 plus line 2) (3) Dwelling (4) t'71,--‘4,-k ._.. ... .£ 1 1 : T n4 Residential improvements or Annually Assessed Mobile I Manufactured Home Garage (5) t"„ V?-7rt-:: _..-Cie -f -':...e Other improvements (6) ';-'1,e,----.J.„--6--,-1,(< Total improvements(line 4 through line 6) (7) Total value (line 3 plus line 7) (6) Signature of Assessor Date signed(month,day,year) I hereby certify the above is true,Correct, and complete. Verifying action-Signature of Auditor Date signed(month,day,year) -Si;r1,9zS d+r _;r lj R i stil gSTANCepicEDUCTIONTAL'LOWANCE CA.g ra+`-;-.ata-ta?Y 1Ti 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 toe 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-hat )of he assessed value of the - home or manufactured home. Signature o A .ii. 0 Date signed t ay,ro