HomeMy WebLinkAboutHomestead_Reavis^ CLAIM FOR HOMESTEAD PROPERTY TAX
N � STANDARD/SUPPLEMENTAL DEDUCTION
i.� State Fortn 5473 (R72 / 6-09)
�� : Presrlihed by Ne Depanment of Local Gwemment Frarce
INSTRUCTIONS: See raverse side for filing instructions.
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I(We) �i certiry that I(vre) occupi�ed jas my (our) prindpal
place of reside or am (are) buying the tollowing descrihed real property for which a Homestead Property Tax Standard Dedifcfi�a?tspeRby�aimed
,,u_n,(der convact on ihe date this appliration is filed, (date offiling): GIBSON COUNTY AUDITOR
hC I I(We) own ❑ Am (are) buying under recorded conVac[
LJ�(are) entltled to occupy as a lenant-stockholder of a cooperative housing corpo2tion
� Have a benefidal interest in �he Wst or the right to occupy the property under ihe tertns of a qualified personal residence Wst
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spause
If buying om m�tred, Fea Simple owners nama
RecoNers office where mnvacl is recorded
Counry
of da"imant (6st (rve U'
tounship)
RemrA number � Page
wmber Legal d?� tlon Is` �,h.�a �operty fn 9uestion:
�2 �' a9 �0 00 S` .�/oJ' G�-/ I`1CJ �a� ��^�' ❑ A^^�Y assessed moEi�e home (IC Gf.1-7)
xtion ol Ne re5idenlial sWC4ire ot Ne IafW nol exceedi� one (1) arfe that immeAiatey w rMS ihat swcNre is used �n produce �ncome, tlesrnbe �he use and portqn
mperty uWaed b D�uce income.
���, a�Pac�l.' �,2, �� � o
TownsNp
I hereby ceniry ffie above statements are we, correct and complete.
Land not exceeding 1(one) acre immediauly
Otherland
ToUI land (line 1 plus line �
Residential
Assessed N
Dwelling
Garage
Other impmvements
ToUI Improvements (line 0 NrougA line �
Total value (line 3 p/�s Ilne 7)
I hereby certity the above is true, cortect,
veityin9 arfion - Sgrenne W Auditw
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(Z)
(3)
(4)
(5)
(6)
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ofAssessor
Counry
ot
20 _ pay 20 _ Lesser of 60°6 of the assessed value of the homestead or 545,000
FlpfwithslarMing any otherpiovision. Ne sum Nthe dedurlionsWovitled in IC bi. f-17 ta a mo0de hortre Uut is
rot essessed as reel propeM � ro e menu/ucfured hwne Net is nof assessed as real properry meY �t esreetl
....�,�xi�rn N rnn wccnccaA value d fhe mobde Mme w manufaUUred hortre. .
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Twrtaitip
Date 5lgnetl
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Signature of Auditn I Date si9ned (monN.