Homestead_Naas (2)°'" CLAIM FOR HOMESTEAD PROPERTY TAX
r.A- r � CREDIT/STANDARD DEDUCTION
Slala Fortn 5473 (R8 f 7-07)
•� �,• � PrescriDed by Ihe Departmeni of Local Government Finance
INSTRUCTIONS: See reverse side for fifing instrucfions.
FORM YEAR
1 M1e) ��-�a(i�QJ �'- � ��e� �/' certiry that onl��a� 20_
i(VJe) xwpied as our prindpal place of residence 1he following described reai property fw which a Homestead Property Tac it is h b� ed:
-� GIBSON COUNTY A 01�
,i(We) owned ❑ Are buying under mntracl
Have a benefioal interest in the entity that is liable fw the property faxes on the property and that owns the property or is buying under a contrad.
If buying on contract. Fee Simple ownets name
Recortler's offica where conUad is recorded
Caunry
Twnship
Tazing distriq (cdy. (o.m. faumship)
Record number � Page
1 1�-0 �� � o�_ o o�. �4 de�ri� I I Is Ihe P�oPa O�Real proPartY ❑ Mobite Home (IC 67. f-7)
��-�-0
I( any poriion of the resitlential sirucWre w Ihe land not ezceeding one (1) acra that immediately sunounds Ihal structure is used ta produca inmme, describe ihe uu and portbn
W.Iha vroperty uliGZed In P��e inmme.
� I�:��,."�' G�,,n, t � I�ala�
... . ,: . .
County I Toxnship County Tavnship
i hereby cerlify the above sfatements a2 true, correcl and compiete. a
�4 s(number eM sLaeC crty, state. and ZlPCOOe)
, �s r�N� N G� ��GGS
,_ , . . .. . .
„.. �
Land oot ezceeding 1(are) aae immediately - - .
surtounding residenfial improvements. (�� ' - _ .
Other land (p� � �
TUaI land (line 7 plus line 2) �3�
Dweiling (4) ' ' � � . . �_
Residen6al imprrnements or Mnualty � - '
Assessed Mobile / ManufacWred Home I � ' � � � '
Gara9e (5) .. .. _ .
Other improvements (6) � -
Tctal improvements (line 4 through line 6) �7�
Tdal value (line 3 pl`s line n (g�
I hereby ceAify the above is We, cortect, and Signawre of Assessor Da1e sgnad (monfh. day yeeq
complete.
Vaitying adion - SignaWre ot Auditor Date signed (mmfh, day, year)
tu _ PaY 2� _
Lesser o1 7l2
Homestead Valuation
w
SgnaWre of Pndimr
45,000 tor 2007 pay 2008 42,000 for 2010 pay 2077
44.000 for 2008 pay 2009 47.000 for 2011 pay 2012 S
43,000 for 2009 pay 2010 40,000 payable after 2012
' . I 7
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