Homestead_Binkley ne. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
:A_ i STANDARD I SUPPLEMENTAL DEDUCTION FORM
Sate Form 5473(Rt5/614) HC10
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
'r; . - 'CERTIFICATION STATEMENT -.z__ ` . 'tip.'
I(We)�ll!/.ra!'��5� 'ET ` s/•re. that I(we)o : -. ``,.m!(our); n tr! -•
place of residence or a (are)buying 'following described real property under contra Il or which a Homes t-ad P.•- , _.- •- l •
Deducts is hereby claimed on the d.,e this application is signed. (date of signature). I(We):
[� a�n. 1:1 Am(are)buying under recorded contract. DEC 1'2 2014
❑ 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 person- residen - tru
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. e/
- L y1- --r - '' CLAIMANT'S iNFOlwunON. __ w 2 s\,� ;,nn'X67t ITOR
'Recorder's o5ce where contact n recorded Record number Page
4T-.-&, ._ ;-.__t-t•-:•2.717-.PROPERTY` DESCRIPTION .e•!:- 21.....-4-:;-1— 'ss=-f .e.-'�:.s
Casey Tonnsblp Taxing disbict(city,tavn,township)
Parcel number J� Leeggallddessm�_rK1eon �'''1 l/:]/ ,r,1/�f Is the proper quessiwc
-1 V - 3t0-35o CLLR. J' '7 1 ealpropeM ❑ MnaN assessed mebie home(/C 61.1-1]
If any portion of the residential=Cure or the and not exceeding one(1)acre that immediately surrounds that sl Cure is used to produce income,describe the use and portion
of the property ticked to produce Income.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate,Casty,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
•inatuwe of dad.—am _
I hereby certify the above statements are true,correct,and complete. /X\
Add-0 f contact(number and 'eel oty slate,and ZIP code) en/Se s of vacated homesm[�and sf cry flare.and P code)
10313 5. PIIEAc4Vi RuA/ -v35t2t 44 .3i'
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NON-RESISIDENTIAL
VUE
Land not exceeding one(1)acre immediately I(1)
surrounding residential improvements
Other land 1(2)
Total land(line 1 plus line 2) I(3)
Residential Improvements or Dwelling I(4)
Annually Assessed Mobile I
Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7) .
Total value (line 3 plus line 7) (5)
I hereby certify the above is love,correct. Signature of Assessor (hue signed(month.day.yew)
and complete.
Venlying action-Signature of Auditor Oath signed(main,day,yew)
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000 q
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $ DEC 12'2014
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed one-half(U2)of the assessed value of thhee mmoobiee home or manufactured home. /7
Sga:ure oliM� Dee signed//S�7I.t day,ye
GIBSON COUNTY AUDITOR
DISTRIBUTION:Original-Casey A:tax,Fie-Vamped Copy-Taxpayer