HomeMy WebLinkAboutHomestead_CaudillCLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD / SUPPLEMENTAL DEDUCTION
i V State Form 5473 (R12/&D9)
•� Prescribed by the Department of Loral Govemmerm Finance
INSTRUCTIONS., See reverse side for filing instructions.
FORM YEAR
HC10
FILED
01
CERTIFICATION STATEMENT
1(We) certify that I (we) occu s my (our) principal
place of resideV or are) buying the following described real property for which a Homestead Property Ta1GSS* ction Is hereby claimed
act on the date this application is filed. (date of filing):
own ❑ Am (are) buying under recorded contract GIBSON COUNTY
rAl
AUDITOR
e) entitled t o 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
Nam dai yt (legal name)' ,
Social Security number of claimant's spouse (last five dgds) Drivers license I Identification / Other number Issuing State
of claimant's spouse (last five dgibs)
CONTRACT ••r .
If buying on contmct Fee Simple owners name
Recorders office where contract is recorded Record numtxv Page
PROPERTY DESCRIPTION
County
Township
T dstrio . town. t ip)
r
Real r
Oy assessed rtph7e Inorne (IC 6. 1- 1-7)
If any pomm of the residential stn ours or the ladl not exceedug a» (1) acre that immediately surrounds that structure is used to produce income, descnbe the use and Portion
of the property utilized to produce Income.
PROPERTY OWNED BY
County Township County Township
I hereby certify the above statements are true, cortect and complete.
gnature of
Addr as (num and street, crry, state, and LP code) / G
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE I HOMESTEAD NON-RESIDENTIA
AT rr'. OF
Land not exceeding 1 (one) acre Immediately" "'4'f+
(1)
surrounding residential improvements.
MMM
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential Improvements or Annually
Garage
(5)
ri"-
Assessed Mobile I Manufactured
.'ar:4�,s.•<
Other improvements
(6)
T
4r,
Total Improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(B)
hereby certify the above is true, correct,
Signature of Assessor
Date signed (month, day, year)
and complete.
Veifying action - Signature of Auditor
.Date signed (month, day, year)
STANDARD • r
20 _ pay 20 Lesser of 60% of the assessed value of the homestead or $45,000
No wiMstandug any otherpmvuuon, the sum of the deductions provided in IC 6-1.1-12 to a mobile tame that is
$
no assessed as real poperty or to a manufactured home that is not assessed as real property may not exceed
one-half (12) of the assessed value of the mobdo hone or manufactured home.
Sgnawre of PuNto
Dale signed (manN, Qay, year)
01