Homestead_Lienemann (5) 4e "� CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
14_n ` STANDARD /SUPPLEMENTAL DEDUCTION
State Fond 5473(Dep/12-09)
1 Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. ' I Id
/ :; 6.0-fIF!CATION STATEMENT
I(We) ∎d...t 1 S/ 0- //-iii / - —A/ certify that I(we),6 upied , nrJ'principal
place of residence or am(are)buying the following described real property for which a Homestead Property Tax Standa t i eb claimed
GIBSON COUNTY AUDITOR
under contract on the date this application is filed, (date of filin g) I(We):
0Own ❑ Am(are)buying under recorded contract
❑ Am (are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation •51t S6$- 99 7 7
❑ 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.
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>r: _ •.- _ '--:-c,:
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number 1 Page
,I
'OPROPERTY DESCRIPTION
County Township Taxing d' 'ct(city,t wn,township)
Parcel number Legal description I tthhgyyfoperty in ques O:
Ra,,/7/7_0.6,- GO/I 0.2..a21 IZq Real property • ❑ 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 sunou(nds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
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' _ r- PROPERTY/,OWNED BY CLAIMANT IN OTHER COUNTIES - - - --
County Township County Township ..
I hereby certify the above statements are true,correct and complete. Signature of nt - / - ..
Actress(number and street,city,state,and ZIP code) -. - . .
// C. S ■ d f,+ bcc . i, 4 670
SSESSED.VALUE ,,ASSESSOR USE ONLY _ - rTRUE TAX VALUE AT 100%OF TTY I H _VALUEAD I NON-VALUENTIAL�
Land not exceeding 1(one)acre immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line I plus line 2) (3)
Residential improvements or Annually Dwelling (4)
Assessed Mobile 1 Manufactured Home Garage (5)
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)
' - STANDARDDEDUCTION ALLOWANCE •
20 pay 20 Lesser of 60%of the assessed value of the homestead or 645,000
Notwithstanding any other provision,the sum of the deductions provided in IC 5-1.1-12 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-half(1/2)of the assessed value of the mobile home or manufactured home.
Signature of Auditor . Date signed(month,day,year)
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