HomeMy WebLinkAboutHomestead_Collins (2)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDMSTANDARD DEDUCTION HC10
State Forth 5473 (8715 -06) ^ `
Presoibed by the Department of Local Government Finance (V�Nvj
INSTRUCTIONS: See reverse side for filing instructions.
e) orxupiad as our prirldpal place of " erlce ti1e folbwing described real property for which a Hamesd4ro Tax aimed:
r(We) owned ❑ Are buying under contract gg
ave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the propE'or i2btOrtfler a contract
�;a'o ,qA"V? CONTRACT.RECORDmi
N buying on mntraa. Fee Singrle owners reme -
GIBSON COUNTY AUDITOR
Recorders office where .lb cl is recorded Record number Page
PROFERTY:DESCRIP770N: e�!T4�i��'�r �. d %- 1'.idn.Fr�'.."aXLL��`.."E°.`:
County
Township
Taring district (cdy town, township)
rcei number
Legal descii '1
Is fine property m question:
I-
), 1-3-1.11
❑ Real pub ❑ Mobil. Home ( /.C. 5- 1.1 -7)
Marry portion of the residential structure or ft lard not exceeding one 1) acre that immediately surrounds that structure is used to produce hoome, describe the use and portion
ai the property ulif®d to produce Income.
VR0P.ERT.Y,0WNE1YBY.CL'111MANTr Oi;OTHER COUNTIES'
County
Township
County
r+.r..< -
TIAI.
Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant
La�c4.,r5
(number and sb ast eN stela. IlP coda)
5-lql S. O T
Land not exceeding 1 (one) acre immediately
. N. S' 9 'iekk.R- 3- '�A »W''sKrlru �n -8� 1n'
+�.'1.ktiYASSESSOR USE'ONLY�'3 -ra �r
TRUE TAXA`h +^'t
iy.$y.
r/6SSESSED VAI:UE
�...
HOh1TEAD
r+.r..< -
TIAI.
f-
.+x Sa",k:). �'xss,' ).6i -yr a; . +.,';; dk,t, a`• . t , ev' t
•.-
VALUE _- i,�
, AT�100X OF TTV�'
i�..� }
<NONRE�SIUE StG
s..:. v
Land not exceeding 1 (one) acre immediately
s r ""-yr "- `5 '=.Ib ;;1-.
surromd' m8 residential improvements.
(1)
a4... i. ^ a ?rs'' 7.rvw.tk "»-o, • � �...:
Other land(2)w
'ssttmy +�y"4''
Total land (litre 1 plus lire 2)
(3)
Dwelling
()
Residential improvements or Annually
Assessed Mobile I Manufactured Horne
Garage
'�.cy�{Y 7"rv' ^`fK�oyf3
(5)§-
Other improvements
(g)
Total improvements (Are 4 through Eno 6)
(7)
Tdal value (Ifrre 3 pins fine 7)
(S)
1 hereby certify the above is We, correct, and
Signature ofAssesser
Date signed
complete.
Worrying action - Signature of Pudnar
Date signed
20 _ Pay 20 _
Lesser of 12 Homestead
Valuation or $35,000
signed