Homestead_Takacs CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
4 STANDARD /SUPPLEMENTAL DEDUCTION z CRu
State Forth 5473(R13/12-09)S Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
. CERTIFICATION STATEMENT ,•,x '
I(We) _ L x 1/d f �' Ali Z/_�9a:� / . certify )-- I h, e) //p',-, :s I r)principal
place of residence or am(are)buying the following de %'bed real property for which a Homestead Property 2' Stari.ar Ll s tic Ion Is ereby claimed
under contract on the date this application is filed, (date of filing). I(We): _ OCT 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 persol petip¢fM�sj
❑ Am (are)the shareholder, partner or member of the entity that owns the property. GIBSON COUNTY AUDITOR
.44*A , 4u. -_? Ya`.- _ - :--,aLAIMANTS INFORMATION, "w 7_.•'r,.r .,,_-_7:-, ,''� i. ' e z'
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- - . - — _ . . _ CONTRACTRECORDED,;-'- - _ _. - _ -.ca• - "lig
If buying on contract,Fee Simple owners name .
Recorders office where contract is recorded Record number 1 Page
.1
County Township Taxing disbict(city,fpwn,township)
Parcel number egal description , 7&O7 97I Is property in question:
a Real property ❑ Annually assessed mobile home(/C 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)ace t immediately surrounds that structure is used to produce income,desaibe the use and portion
of the property utilized to produce income.
2(o — le— 3&- 360 - oo .Z . 58o _oaie
- PROPERTY OWNED.BY CLAIMANT IN OTHER COUNTIES - ,•
County • I Township County - -- Township
I hereby certify the above statements are true,correct and complete. I mre of claimant
Address(number and street, state,and ZIP code)
/t' 1 III h _1.._ qns - ILO ,i1IX\1 ck
1ASSESSED I HO HOMESTEAD I e NON-RESIDENTIAL ASSESSOR USE ONLY TRUE TAX VALUE VALUE
Land not exceeding 1 (one)acre immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Annually, Dwelling (4)Assessed Mobile/Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
I and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
_ _ •
ST.__ __,_____ION ALLOWANCE - _
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-I.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-hall(12)of the assessed value of the mobile home or manufactured home.
Signatur of Auditor s Date signed(month,day,year)
4iC. c. . .. a;,