Homestead_McKinney (4),�. ° CLAIM FOR HOMESTEAD PROPERTY TAX
y. -- > t CREDIT/STANDARD DEDUCTION
` � t State Fortn 5473 (RB! 7-07)
Aesuibed by Ihe Department of Laal Govemment Finance
lNSTRUCTIONS: See reverse side Ior filing insbuctions.
FORM YEAR
FI
� M�e) 1�V� IT b.IIJ 1V I\.Vl. ��m ce ' or�t day ot Marcli. 2b_
I(We) ocwpied as o �napal place oi residence Ihe folbwing described real F erty fw which a Homestead P rty T�edit is hereby daimed:
GIBSON COUNTY AUDITOR
'`� I(We) owned ❑ Are buying under wntracf
Have a benefidal interest in the entity Nat is IiaWe fw the property taxes on the property and that owns the property or is buying under a contract.
If buying on conUaq, Fee Simple owners name
RecordMS afice where conUact is recortled
Counry TawraNp
fown, fa+vnship)
Racord number I Page
� ��n/��ll�.Jl.V'WD.�e'aldes�Plion��L_� (IStheW ��RealProPertY ❑MObileHome(IC64J-n
�
If any porGon of the residen6al swcWre or iha land nIX exceeding one (7) acre ihat immediately surtounds that structure is used to produce inwrtre, desclibe Ne use and portion
of Ne yoperry u64zM lo Produce incorne. n. �W ,^ .
M � �
•�• • � : • �
County I Tavnship County Township
I hereby certify Ne abwe s(atements are true, correct and complete. Signat r of daimam -
�ress (numbe� arH�, dty stafe. anOZo cotl�
7 �'' �wensV%.� �/i✓ �/ 6CS'
.- .
. . .. . .
�� ..
Land not ex�ng 7 (orre) ave immediatety :. - ' � ` � -
surroundingresidentialimprovemenfs. ��) . ' � .-
OMer land (z� � '
Tdal IarM (line 1 plus tine 2) �g)
Residential improvements wMnualiy �elling (q) r _"" , - . _..�,II_:; �� -
Assessed Mobile / ManufacWred Home t•Y '�
Ga2ge �5� ;� �'.:i,i
Other improvemenCS (6) -
Tdal improvements (line 4 fhrough Gne 6) �7�
Tofal value (line 3 pl's lirre � �g�
I hereby terti(y the above i5 We, correG, and SignaWre of0.ssessw Date signetl (monfh, day, year)
wmplete.
Verifyng acUan - Signa4ue oflwditnr Da�e signed (monN, tleY Y%��
�u_pay20_
Lesser of 7Q
Homestead Valuation
w
Signature Nlwdilw
45,000 tor 2007 pay 2008 42,000 tor 2070 pay 2011
44,000 tor 2008 pay 2009 41.000 tor 2071 pay 2012 $
43,000 for 2009 pay 2010 40,000 payable afler 2012
Da�e signed (rtrcnth. day,
�1 g' g_ _' _F1. 7r�
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