Homestead_Clifton ' CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
ft--; ` STANDARD I SUPPLEMENTAL DEDUCTION FIRM
State Food 5473(R1515-14) '11010
✓ Prescribed by the Department of Local Government Fiance
INSTRUCTIONS:See reverse side for filing instructions
NOTE:Telephone,Social Security,driver's license,state identification and federal identfrcarion numbers are confidential under I.i• . -1'37.i
- ■ CERTIFICATION STATEMENT' c ._ ' '
I(We) i&' 3JJ1` •a certify that I(vie)occupl1.as my(our)pprincipal
place of residence or am(are)buying the toll I 'rig described real property under contract for which a Homestead Prope ax Standard
Deduction is hereby claimed on the date this application is signed. (date of signatu 1jV' ): 2015
❑ Own. ❑ Am(are)buying under recorded contract.
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. I ei"
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified persona Q='[ih- twAr^^Ih
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. GIBSON COUNTY AUDITOR
_
"-: _ _
If buying on contact.Fee Simple owner's name
'Recorder's o5ce where contract S recorded Record number Page
n `'- y. ' ,-.4.-c.. - -F PROPERTY DESCRIPTION'• t. - _
County Township - Taxing disnd(city,town towship)
P m legal
descnpoon
W� =' ■-
I Is the pro al p open ❑ Annually assessed morale Mme(IC 6-1.1_7I
It any poten of the residential struSure or the lard not exceeding one It)arse that i::iediately surrounds that exudate S used to produce income.desoibe the use and pottgn
d n 7qr r7.q 3 0I CCOa &6tD07
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate,Caney,and Township Is claimant vacedng a homestead?
// //'�❑ Yes ❑ No
Sgw:una� (MY
I hereby certify the above statements are true,correct,and complete. j`ign
Address of coma(num end 4 e•Y. ate se •ZIP code) (Address vacated hw..stead,It any( end street,nay.state,and LP die)
5 - I a Cs► ( ♦ 660
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL
Land not exceeding one(1)acre immediately I(1)
surrounding residential Improvements
Other land I(2)
Total land(line I plus line 2) I(3)
Residential improvements or Dwelling I(4)
Annually Assessed Mobile I
Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (6)
I hereby certify the above Is true,correct,
Signature of Assessor DYx signed(nov'c day,year)
and complete.
Va yvg action-Si neture of Audtor Date signed(month.day,ye
• I ; 3 I !
'LL i-;T^'STANDARD DEDUCTIONALLOWANCE'.: _y'':` 1F 4- 4rTCt_=i.=
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $ AUG 3 2015
that is not assessed as reel property or to a manufactured home that is not assessed as mat property may
not exceed e-haff(1/2)of the assessed value of the mobile home or manufactured homme.. /1
Signature of da 11' 1 • - / , �f V— Daa t Car.l'eadl ai
,1✓'.,ayl •N7J�J/TV Rd �_ k.d a�)./ -h
U165ON� O4 ' Y AUDITOR
DISTRIBUTION: Original-Com•YAW.tor,Fie-&ed copy'Taxpayer