Homestead_Morgan (7) ry:re: CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
..' .Ci-ttrV STANDARD /SUPPLEMENTAL DEDUCTION FORM
--,,if,„cLe State Forrn 5473(R13/12-09) HC10
Prescribed by the Department of Local Govemment Finance
INSTRUCTIONS:See reverse side for filing instructions.
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I(we) al";Sinai SS 0 2 f a-7,-- certify that I(we)occupied as my(our)principal
place of r , nt,/f am(.. .uying the following iesaibejfal property for which a Homestead Property Tax Standen:Wu:St iilatitby claimed
Or
under •. ...cA on the date .s application is filed, (date of Wing). I(We):
XOwn 0 Nn(are)buying under recorded contract
Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation
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GIBSON COUNIY AUDITOR
0 Have a beneficial interest in the trust or the right to occupy the property under the terms of é qualified personal residence fruit
0 Am (are)the shareholder, partner or member of the entity that owns the property.
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If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
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County Township Taxing district(city,town,township)
Parcel number Leiat71 inalption Its thErperly in question.
Wfr .5- 3 - 9 Real property ID Annually assessed mobile home(IC 6-1.1-7)
If any rani f the residential structure or the land not exceeding one(1)acre that immedia nds that structure is used to produce income,describe the use and portion
rsiof the pro Mixed to produce income. Clier"ucgia
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County Township
I hereby certify the above statements are true,correct and complete. • ,
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-•• - (number and street,city,state,and ZIP code) I 1 f ‘' 9 .1111.M111
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Land not exceeding 1(one)acre Immediately .•-•,73_,it-tr:-P"...4.it-C:``k•I:f.e;9-14-,,,f
surrounding residential Improvements. (1)
".• --r-Tie 24‘.1.::;.-":
Other land (2)
Total land(line I plus line 2) (3)
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Dwelling (4) ...,f.A.-4-2,:73,1‘.. Irm.--niulec[Y,3..i;••'-•,--(--,:,
Residential Improvements or Annually
Assessed Mobile/Manufactured Home tv,,z;---r•1/2s.:4;.,..,..,,::-,••-•,---L-4,:—.74:-....lify:
Garage (6) .:-.-,(.., - -:••:--.71.?:k-r-111::Crik
Other Improvements (6) :".
Total improvements(line 4 through line 6) (7)
Total value (fine 3 pas fine 7) (8)
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)
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20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other arm/71ton,the sum of the deductions provided in IC 6-1.1-12 to a mobile home that is $
not assessed as real properly 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.
Signature of Auditor Date signed(month,day,year)
. .