Homestead_Logestan ".4 CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
ie._. _ STANDARD /SUPPLEMENTAL DEDUCTION HC10
State Fowl 5473(R13/12.09) •
1 Prescribed by the Department of Local Government Finance I ` f '
S •
INSTRUCTIONS:See reverse side for fflirt instructions. ',t
�_I�� �i. 1�� 7 ,/I;�H•��CERTIFICAT.CN STATEMENT - ��f1,,II rrff - _
I(We) '�// !Tlirilv�� 7er/s�e- d / • ,/ ��.. certify that 11R$61wc upieaO}4ny(our)principal
place of residence o Q (are)buying the following described real property Jr which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the rate this application is filed,_ (date of filing). I(We):
❑ Own ❑ Am(are)buying under recorded contract GIBSON COUNTY AUDITOR
❑ 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. �•eqr
_-- .: te _'T7.' nCLJIIMANT'S:INF_ORMATIONt =.•;fa� gt .224
If buying on contract.Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
County // Township Taxi • •stri city,town, wnship)
Parcel number Legal description I th roperty in question:
Real property ❑ Annually assessed mobile home(IC 61.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surro nds that structure is used to produce income,describe the use and portion
of the property util eed to produce income.
dd-/5 -31/1- 0:29- �/�-Old
. . , �,:• d,yr•� n _-.y-aPROPERTYiOWNED_BY.CLAIMANT•IN OTHER•COUNTIES . t, - -
County I Township County - Township
I hereby certify the above statements are true,correct and complete. Signatureio daimant
�.�/ Agri __
••dress(number and street,city state,and ZIP code)
a S •CO &.Klan. C: ( 7(O4Cb
ll ASSESSORTU ONLY -^- ;I TRUE TAx V U I AS9ESSED.VA'LUE,I HOMESTEAD •I}_ NON=RESIDENTIAL-7,7-_,
a '� -_ L7,7-atirrVALUE.a• -:.-VALUE :'•-: "'-'t�
Land not exceeding 1(one)acre immediately
surrounding residential improvements. (1)
-
Other land (2)
Total land(line 1 plus line 2) (3)
Dwelling (4)
Residential improvements or Annually
Assescad Mobile I 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)
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 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(12)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)
•