HomeMy WebLinkAboutHomestead_Burgess (2)CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD / SUPPLEMENTAL DEDUCTION
State Fonn 5473 (R1216 -09)
Prescribed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HCtg
FILED
I (We) at I (we) ocalpied as my (our) principal
place of residence or am (are) buying the following described real property for which a Homestea P operty Tau,Sla� ion is hereby claimed
under contract on the date 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
INFORMATION
Name of claim ( at me)
Social Seemly number
Social Security
It Guying on contract, Fee Simple owner's name
Remrdefs office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
Township
inang district (city, ","I ^ '
Pp,,e),numq
to 3 y'
Legal description
Is the prop in question:
of I - �O
. 5 Y-04-If
l property ❑ Annually assessed rtnhile tnme 61.1 -7)
moon of residential struchum or the land not exceeding one (1) acne that Immediately sunounds that structure is used w produce Income, describe the use and portion
Me
of property tow Produce coca come.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County To+rtuship
I hereby certify the above statements are We, correct and complete.
S newre of daimant
Address (numbel and street, dp; stare, agl ZIP ;1e) `
r ., r
ASSESSOR USE ONLY TRUE TAX VALUE
Land not exceeding I (one) acre Immediately
sumoundin residential im rovements. O"= "-"- 1'• -s+w
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
c..y?� ,.'4� #s °}txt[:.•;r;
Residential improvements or Annually
Assessed Mobile l Manufactured Home
:
Garage
`;_:'• -.'� 'v ��sc���"t$.
(5)
-s'"'c
Other improvements
(6)
l
Total Improvements Improvements (line d through line b)
(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.
Verifying action - Signature of Auditor
Dale signed (month, day. year)
STANDARD,DEDUCTION
20 pay 20 _ Lesser of 60% of the assessed value of the homestead or $45,000
Notwithstanding any otherprovision, the sum of the deductions provided in IC 61.1 -12 to a mobile home that is
$
not assessed as real property or to a manufactured home that is not assessed as real pmpenY mitY not exceed
on ) o! the assessed value of 04mobila home or manufactured home.
s w of
itor
Dates
y.