Homestead_Davis (9)CLAIM FOR HOMESTEAD PROPERTY TAX FOR YEAR
CREDIT /STANDARD DEDUCTION 111
State Form 5473 (8817 -07)
s
Prescribed by the Department of Loral Government Finance AUG 1 4 2008
INSTRUCTIONS: See reverse side for filing instructions.
c� J r GIBSON COUNTY AUDITOR
I (we) T certify that on the 1 st day of March, 20_
I (We) occupied as our principal place of resid t,91 the followinglacribed mat property for which a Homestead Property Tax Credit is hereby claimed:
1 We) owned ❑ Are buying under contract
WHave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
If buying on contract, Fee Simple ownees name
Recorders affice whem contract is recorded
P. ROPERTY DESCRIPTION i;s;
Parcel number
Is the
13-j (S-1—I �e l property ❑ Motile Home (IC 6- 1.1 -7)
If any potion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that stmcure is used to produce income, describe the use and portion
of the property utilized to produce income.
A REEMmil r • • • • r
20 _ pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation S
W 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor Date signed (month, day, year)
rr ..
Land not exceeding 1 (one) acre immediately
r `,�
surrounding residential improvements. (1)
Other land
(2)
-
Total land (line 1 plus line 2)
(8)
Dwelling
(4)
-
Residential improvements or Annually
Assessed Mobile l Manufactured Home
Garage
(5)
Other improvements
(6)
Trial improvements (line 4 through line 6)
(7)
Total 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 Auditor
Date signed (month, day, year)
A REEMmil r • • • • r
20 _ pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation S
W 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor Date signed (month, day, year)