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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
` ✓ Slate Form 5473 (R817 -07)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC7D
FlLED
I (we) _L„��1JldC5L LA 1 A✓ JLXdV\ certify that on the 1 st day of March, 2(1_
I (We) occupied as our principal place of residence the following described real property for which a Homestead ero, 4T is hereby claimed:
IJ I (We) owned ❑ Are buying under contract GIBSON COUNTY AUDITOR
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.
CONTRACT ••r .
If Drying on contact, Fee Simple owners name
Recorders office where contact is recorded Record number Page
County
PROPERTY DESCRIPTION
Township Taxing disinct (city, town, lwnship)
Parcel number
Legal description
Is the property in question:
_
I El Real progeny ❑Mobile Home (/C E1.1 -7)
if arty portion of the residential structure or the WrW not exceeding one (1) acre that immedately surrwnds that sWCWra is used to produce Ncome, describe the use and portion
of Ua property utilized to produce income.
LJC&d&&&A3'c�dJ
Twnship
I hereby certify the above statements are true, correct and complete.
County
ASSESSOR USE ONLY
VAL
TRUE TAX UE
!ASSESSEDVALUE
HOMESTEAD
NON-RESIDENTIA
AT 100% OF TTV
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
_x, �. ,.^�.. "-'�.� _ "•
surrounding residential Improvements.
O
Other land
(2)
v ',
,C':;r
Total land (line 1 plus line 2)
(3)
�.
Residential improvements Annually
Dwelling
(4)
x ; --
w
n
Assessed Mobile I Manufactured Home
Garage
(5)
x
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, coined, and
Signature of Assessor
Date signed (month, day, year)
complete.
verifying action - Signature of Auditor
Date signed (month. day, year)
20 _pay 20_
Lesser of 12
Homestead Valuation
w
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
43,000 for 2009 pay 2010 40,000 payable after 2012
I Signature of Auditor -I Date signed (month. day, year)