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Homestead_DavisCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR CREDIT /STANDARD DEDUCTION Hcio State Form 5473 (R8 / 7 -07) nw Prescribed by the Department of Loral Govemment Finance INSTRUCTIONS: See reverse side for filing instructions. I (We) U . t 1 certify that cpn 1�� gf{,t�fch, 20_ I (We) occupied a r principal place of reside the following described real properly for which a Homestead Property Tax r d is ereby daimed: `I (We) owned ❑ Are buying under contract Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the props or lyguying uf(dbr a contract. CONTRACT • -• If buying on contract Fee Simple owners name Recorders office where contract is recorded Record number Page PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County PROPERTY Tamship Taring district (city, town, township) Paul n ben _ _�� L al d nipplI; I Is the property in question: ❑ Real property ❑ Mobile Home (IC 6-1.7 -7) Harry portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income. PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County To,nship County Township I hereby certify the above statements are true, correct and complete. S awn ai M - res um aryelteet ate, andj,(P rode) �—i/Y^ V7J747 F: w I VALUE,. Ed ASSESSOR USE ONLY TRUE TAX VALUE] - AT 100% OF TTV VALUE F: w I VALUE,. Land not exceeding 1 (one) acre immediately - surrounding residential improvements. (1) - Other Land (2) Total Land (line 1 plus line 2) (3) Residential improvements or Annually Dwelling (4) Assessed Mobile I Manufactured Home Garage Other improvements (6)- - Total improvements (fine 4 through line 6) (7) Trial value (line 3 plus fine 7) (8) 1 hereby certify the above is true, Correct, and Signature of Assessor Date signed (month, day, year) complete. Verifying action - Signature of Arditor Date signed (month, day. year) STANDARD DEDUCTION ALLOWANCE, Pay 20 — 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011 Lesser of 12 44,000 for 2008 pay Homestead Valuation pay 2009 41,000 for 2011 2012 $ a 43,000 for 2009 pay 2010 40,000 payable after 2012 Signature M Auditor Date signed (month, day, yea,)