HomeMy WebLinkAboutHomestead_Maikranz (6)CLAIM FOR HOMESTEAD PRORERTY--T A
FORM
CREDIT/STANDARD DEDUCTION HC10
Stale Form 5473 (R614-031
Prescribed by the Depanm'.'.1 of Local Gdvemmenl Finance'
INSTRUCTIONS: See reverse side fri(filirry inslaictmns'a,
YEAR
I (We) V&� s;t-- AA aa cart I I 1st 0--
Prop y
I (We) occupied as our principal place of residence the following described real property for vvhi�J!Homeslef: 11 Le Eli, f MDaimed:
❑ 1 (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 prope4P'R-'2uA
1W AWr a contract.
; L-"CONTRACT'RECORDED.'-- r-_ -' -J '-
If buying on contract, Fee Simple owner's name GIBSON COUNTY AUDITOR
Recorder's office where contract is recorded Record number Page
County
Township
district (city, to".
gal Sort Is the prcr�nRq.uaejsIion
scrip I property ❑ Mobile Homo (I.C. 6-1.1-7)
poltlo Tof the residential
structuroorthe . d not exceeding one (i) acre that immediately surrounds that structure is used to produce income. describe the use and portion
i
property utilized to produce income.
PEkTY,'0WN ED -BY CLAIMANT IN 'OTH ERt0IXNTI
z� JRUEJAXV�a-�i'
I
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
)afur of claimant
4dress (number and street, city, state, ZIP code)
Land not exceeding I (one) acre immediately
,Alt
=—ASSESSOR USE'ONLY'
z� JRUEJAXV�a-�i'
I
HOMESTEAD
NOW
PT RESIDENTIALt�'�
4 7-
�
0
Land not exceeding I (one) acre immediately
0
surrounding residential improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
T
Residential improvements or Annually.
Assessed Mobile / Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
-.Y+ -:As- STANDARD.DEDUCTIONiALLOWANCES7� ,f�j',�,V,.-,Vsra.vv t=�z�*,t I
20_ Pay 2O_
Lesser of 112 Homestead
Valuation or $35.000 S
Signature of Auditor / Oat neda
n L<-�-� - I .
C)