Homestead_Nafei 1"fir CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
STANDARD/SUPPLEMENTAL DEDUCTION OR
xi":;:t.4-4.4. State Form 5473(R13/12-09)
m. Prescribed by the Department of Local Government Finance ._ .1 Q ,flT dll�
INSTRUCTIONS:See reverse side for filing instructions. 1{ 'J. gA�Y
rt a�� y Y y - �5e+. z r . < t -tgrCE.RaIgrrl fall gi T-EMEN T 46"- Y .'-+�- oai*t�wii�aAr r.1P-*,
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I(We) grain
n Lfx ' certify that I(we)occupied as my(our)principal
place of residen•- or a' are)b ng the following described real property for which a Homestead Property Tax Standard DedVGtion is em r cl aimed
under contract on the date this application is filed, (date of filing). I(We):
- • ❑ Am(are)buying under recorded contract GIBSON COUNTY AUDITOR
II 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.
VS:gtaMi:t-u l!_c.iL., irit`g-�_ ..{ ' •kt.:I �CLAIMANi INFO rIV174(51:1S ''-'•`z..tal:1 .'iMicm , ` 4,0•Y..111,4 3i1
If buying on contract,Fee Simple owners name
Recorder's office where contract is recorded Record number Page
^7Stall' i w iiS 4vq,'sx icW .,1t�35� _P,R0ilE ly,DESCRIPT_ION .?.r:_..SSLl,gaElist y,°-' '">z''t tegalu' :Nall
County Township Taring di aid(city,town,township)
Parcel number Legal description Is the property in question:
CU, -3 D •-On • e • l - s• . 11 Real propeny ❑ Annually ay.pssed mobile tome(IC 6-1.1-7)
If any•• • of the residential structure or the land not exceeding one(1)ace that immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce Income.
Fti ,am;µ -tn ,n......,...-...ErgBlie ';
{{ _� �� �� 'o'r�PROPERTrYrOWNEDG)BYjCLt'AIN]ANTy1NaOTHERjCOUNTIESv:;t« ����e`3'.;'.�����_'�,c�,�(kti�i2,;;�, -tiril
County Township County Township
I hereby certify the above statements are true,correct and complete. S'grew` claimant P\ kliaFel__
Add - nu bet- sheet state, e) .
x _• ell & • *01 t 1 A • . 1O
�SSESSOR ttm ONLY ° •" r s`R E T 11VM1L 1 ASSESSED VALUE g ME dirt til;M g- NOt RESIDENTIkal,'I•ra
L"` t MS,OFa .. :.,_.--ra.,i �... t i ri . `-liaiS-AT 100'.�.OFdTTV.aI„ .,exVAL`'UE i� 7E YF VAL'UE ms's }(
Land not exceeding 1(one)acre immediately .. ` '' "
surrounding residential Improvements. (1) -• ' :C'-` ° -
_ _ - N_ .'0.-;•1/4:'.
Other land (2) ..., , ..-
Total land(line 1 plus line 2) (3)
Dwelling (4) ;1;1/445./::?-,yrur '- ' -Residential Improvements or Annually - p
Assessed Mobile I Manufactured Home Garage (5) -' ,, p_',.�4.3fi f<y
Other Improvements (6) <0- ..-..':=1.-
Total improvements(line 4 through line 6) (7)
Total value (line 3 colts 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)
c T
E�i'•Ek�+^ �--"�,'•�1-�a :?.�•L`-, C.�.!r�.ir�ta�i.STA NDARD1DEDUCTfON(ALLOWANCE`,-'r'�e� i�y�E��j}' V�s-w'�:_ r��>.: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/C 6-1.1-12 to a mobile home that is $
no!assessed as real property or to a manufactured home that is not assessed as real property may not exceed
one-half(12)of the assessed value of the mobile home or manufactured home.
Signatu of Auditor 1 Date signed(month,day,year)
s - l7 - ICI