HomeMy WebLinkAboutHomestead_Caudill (2)4 " CLAIM FOR HOMESTEAD PROPERTY TAX
VA ' STANDARD if SUPPLEMENTAL DEDUCTION
A ' State Form 5473 (R12 16-051)
S = Prescribed by the Department of Loral Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HCID
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1 (we) — "� certify that I ur�Loxvpied y(Wour) principal
place of residence or am (ar uying the following described real property for which a Homestead Property Tax Standard 0 duction is hereby claimed
under contract on the date this application is filed, (date of (ling):
❑ I (we) own ❑ Am (are) buying under recorded contract
❑ Am (are) entitled to occupy as a tenant - stockholder of a cooperative housing corporation GIBSON COUNTY
APDITOR
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trus
INFORMATION
Nameof ima al name)
Social Seventy number of claimant's spouse (last five digits) Drivers license / Identification / Other number Iswing State
of claimant's spouse (last five digits)
CONTRACT ••r r
If buying on contrecL Fee Simple owners name
Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION
Caun
Township
Taring district (city, town, township)
yl number ' ^ �� —
(- X /`lC�, l L //T —'�,
Lcg I e O� /
000
Is the property r in question:
al pmpenry ❑ Annualty assessed rtaWle home (1C 1)7)
any portion of the residential structure or the land not exceeding one (1) acre that immediately sunoun al structure is used to produce income, describe the use and portion
�lf
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County Township
I hereby certify the above statements are true, correct and complete.
r of aaima t
Address (number and street, city, State, no ZIP e)
b w�
ASSES r r r
ASSESSOk USE ONLY TRUE TAX VALUE AT tt . ' TTV
Land not exceeding 1 (one) acre immediately a ��i. -'-,' R- �''•'•`
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surrounding residential ire rovements. . - '' (1) '..z =�': ?-*-sTM +•-- s -+ ^`t r-tr
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
tLi1 �Y
X�. -rt' i i 3 : ✓. ea
-
Residential Improvements or Annually
Assessed Mobile I Manufactured Home
Garage
•?Z1"�rq`' ->`.?
Other improvements
(8)
i y
Total Improvements (line 4 through line ej
(7)
Total value (line 3 pis line 7)
(8)
1 certify the above is true, correct,
Signature of Assessor
signed
Date ned (month, day, year)
and complete.
Verifying action - Sgnature of Auditor
Date signed (monN, day, year)
STANDARD r r
20 _ pay 20 _ Lesser of 60% of the assessed value of the homestead or $45,000
Niumthstandatg any otherprovision, the win aline deduction provided in IC 6- 1.1 -12 to a mobfie lame that is
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not assessed as real pmperly or to a manufactured home that is not assessed es real prnpefty may not exceed
one -hall (7 ) of the assess valu of the Made home ornanufaca ed hone.
Sg t
Date s (megth. gay3gar)
/ /U
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