HomeMy WebLinkAboutHomestead_Gaines (2) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
'. STANDARD/SUPPLEMENTAL DEDUCTION FORM
¢'q�{ Sate Fom 5473(RI515-14) HC10
• / Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephorw.Social Security,&Vets license,state identification and federal identification numbers are confdena7 u'.e( 6(.1-12-1. j-\
CERTIFICATION STATEMENT ' , - -.: C.- - /-.-D-.-.1 .
I(We) [�� �j�\I �. • certify that I we occupy y our)principal
place of residence or a r(are)buying the following described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby de,.eta on the date this application is signed, (date p�gatir6 law .•
in 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 qualifi trust.
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. GIBSON COUNTY AUDITOR
�=�}�-., ',]`l: _1:.. -----t- - 'CL IMANf'SINFORMATION a:'."-_.. .=a . -- _.
.I_ clamant(legal name) r Telephone number of clamant
tale nikiA (3Q -tag 19 i I
Sodal Seamy number of c: ant y.st five digits) Omers Scene/Went-Seaton l Other number Issuing Sa's
48 ' o of claimant(last five d4as) 5 5 6 2? T
Name of claimant's spouse(legal name)
11 5 v.7 �.1 ..±V
W I Security number of claimant's spouse(last f digits) Drivers kense l Wentacation l Other number Issuing Sate
of claimants spouse(last five dgls)
di ''¢ 5;.c _?a r r-1'_: OONTRACT.RECOROED t.-C .'f-,1 .1.--•::_.r -WS _ i `,?z
If buying on contract,Fee Simple winters name
Recorders office where contract is recorded I Record number Page
_ _s3.: r-Fa+ 44..=1-`.X°°.
[may:-, i_.;.-':??$c�_-Sr:'_�.-�. �.�.;-._ a L,-°'PROPERTY DESCRIP710N� iid��."
(ratty,town,township)
lipt • -
&1/1-I1—I_I—&�O.Oe t/ yea al Mofxr sty ❑ Annualy assessed mobile home(IG 6-El-T)
If any portion of the residential seucore or the land not exceeding eLNone'(I)acre that immediately surrounds that structure is used to produce income,describe the use and portion
of the property utd¢ed to produce income_
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate,County,and Township /! /.,,,.,�, /^1,', ,.y�n Sigma:( Is claimant vacattg a homestead?
T_I jC�ICir)Q LJ/ 1 W. // lV�i /112�j ❑ YesNo
l / : m Itlaimam
I hereby certify the above statements are true,correct,an complete. S (\
D �Jy
Address of contact(number and meet my.slate,and ZIP code) fob,��,"71-7 Address'of vacated homes:ae,if any(number and street.ary,state.end ZIP code)
2. .I
S-''f i tl % . LA 1.(ere Jr-
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL
Land not exceeding one(1)acre immediately i(t)
surrounding residential improvements
Other land 1(2)
Total land(line 1 plus line 2) I(3)
Residential Improvements or Dwelling (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) (8)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month.day,year)
and complete.
Vaiykg action-Signature ofvudlmr Date signed(month,day,year)
1
( t I
rege .71` cz=� 2'° %STANDARD.DEDUC ON ALLOWANCE:-4:2 a:f..L Lr Y'`i—€n` . -
L
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 S DEC 16 2014
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not ex.--.one-half(12)of the:ssessed value of the mobile home or manufactured home.
Sgray.:of .tor ULU- - / Date 4 (month,;,ye:xl
GIBSON ••
DISTRIBUTION: Original-Corny Audna;Fie-Stamped Copy-Taxpayer