HomeMy WebLinkAboutHomestead_DannerCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (8614 -03)
Prescribed by the Deparhnem of Loral Government Finance
INSTRUCTIONS: See r6vw" we for ong iu6uouclm
FORM � PEAR
HC10
-ED
I (we) % 4-LX Yom( /U— („w L`SL.R�/I.IL 0-, � J ,t^ certify that on the 1st day of March, 20
1 (We) occupied as our principal place of residence the following described real property for which a Homestead Propvq �redit ereby claimed:
❑ I (we) owned ❑ Are buying under contract F�
GIBSON COUNTY AUpITOR
' Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
EDeesi -x
t �_
1 '°�,.,iT,r.eCONTRACT.'RECORD -x�.sa 1?+2�• -s _ , _,_ ��;:,- ..:..,�r`''�t:
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
f.._¢� �u __ _.. ____. .__„ _ _. _. _ __ _� _ __ -- -
�..tc�ti �'��;'� � -'" ��os:PROP.ERTY OWNEU',BY;CL'AIMANTIN' OTHER'COUNTIES �,."��?;..�fk,.'�"�S'�'. +�''i:`�'�.'t�
County Township
County
Township
Taring district (dry, town, township)
P 1
r
W
Legal cri i
�j
Is the property in question:
❑ Real property ❑ Mobile Home (I.C. 6f.1 -7)
H any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
f.._¢� �u __ _.. ____. .__„ _ _. _. _ __ _� _ __ -- -
�..tc�ti �'��;'� � -'" ��os:PROP.ERTY OWNEU',BY;CL'AIMANTIN' OTHER'COUNTIES �,."��?;..�fk,.'�"�S'�'. +�''i:`�'�.'t�
County Township
County Township
I hereby certify the above statements are true, correct and complete.
i claimant .
ress (number aM street, city, state, ZIP code)
10 l7
f ry`iC?Hyar -a' `'ate "utR.nj i, ��'SL1c�� 4
"L iASSESSOPoUSE ONLY ""
^YS g
i TRUE TAXi '
--v
ASSESSED VALUE
s?HOMESTEOJ'
NON= REStDENTIAI
.`VA uj&— s.
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
1
Other land
(2)`��`
r
''H Mm nVI&4
Total land (line 1 plus line 2)
(3)
(Residential Improvements or AnnuaOy
Attsessed Mobile / Manufactured Home
Dwelling
Garage
(4)
.l
t iP t o- Mg x~ .rz�y'c 3
€.txu'�
Other improvements
(6)
— '3.39'' Si
++s =.�F:.
Total improvements (line 4 through line 6)
(T)
Total value (line 3 plus line 7)
(S)
-
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
20_Pay 20_
Lesser of 112 Homestead
Valuanon or 535.000
Signature of Auditor Y y ILUA— U — IDate;,yled�S —0 5_