Homestead_Lankford �. - CLAIM FOR HOMESTEAD PROPERTY TAX YEAR 6
tea-; STANDARD I SUPPLEMENTAL-DEDUCTION FORM
- State Finn 5473(R15I5-14)
H
'-` Presaihed by the Depannent of Local Governmerd France t
INSTRUCTIONS:See reverse side for CEng instmc ors '
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NOTE:Telephone.Social Security,drivers f : se.state idenfiii atio•a •federal identifrafon umbers are confidential under IC 6-1.1-12-37. I
' . T . Z' . 'CERTIFICATION STA-EMEN ,_ , f` Fitirtri /(:':e$A51r J
I(We) 9W Tte }a� ify
that I(we)occupied as my(our)principal
' place of residence or am(are)buying -fog• V g•esscribed real property un•er contract for which a Homestead P a,-ry Tax San•
Deduction is hereby claimed on the da E.this a••.i-=tip n is signed, (date of sig-,:•-i: "iiirtry 114
❑ Own. ❑ Am(are)buying under recorded contract GIBSON COUNTY AUD TOR
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust .
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
��,
If buying on convect.Fee Semple wnels name
Recorders oSce where cortrad is recorded • Record number 1 Page
s a -. a idled "in t�3_• _PROPERTY.DESCRIRTION 7_y (°- G= '' • (' :a=_�= -Y55-
is • `a _ • . e fLL
arm(number �y� legal ddesaipion Is`the epproperty n quesi :
! e— IH -(al WI. .*. 7-03-Z) � ITeal Nodally ❑ Anna%asessed=tie home ucit.f-n
If any portion of the residential=moire or the land not exceeding one(1)acre that iimmediated surrounds that scud=is used to produce income describe the use and portico
of the properly nined to produce income.
r . - PROPERTY OWNED ELSEWHERE BY CLAIMANT it
S''e,County,and Township Is claimant vacating a homestead?• I
. . ❑ Yes ❑ No
I hereby certify the above statements are true,correct and complete.
�S/ig[n/S�Ute�la:*cif( (
Address of arras(number and=ere ib4t Sate,and ZIP code) address of vacated hho(mh mestead,c any(number and street.oty state,and ZIP coda) _
f $OL V r4rr4 Av
(�'• ASSESSOR USE ONLY: - I r ASSESSED VALUE I 'IHOMESTEAD VALUE _I- t ;NON VALIDENTIAL
Land not exceeding one(1)acre immediately (11 77
surrounding residential Improvements .� -.�1
Other land - (2) �..<_s.:' i
ITotal land Nine 1 plus line 4 1(3) _ _ I^ - • .- — __ - •
Residential Improvements or Dwelling (4) I
Annually Assessed Mobile 1 -
Manufactured Home Garage (5) ...,,,,..‘"5;;. .-
"•;. -Y -
R .
Other Improvements 1(6)
Total Improvements(line 4 through fine 6) I(7)
Total value (line 3 plus line 7) I(a) -
I hereby certify the above Is true,correct. Signature of Assessor Dare signed(nxnm,say,year)IF Il
and complete.
Vmfyvg ation-Signature dAUd:or Data siyxd(rtaYJS tlay year)
y ?-� enSTANDARDDEDUCTION•ALLOWANCEg,• ` '�y�'-r �`-r.
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Not ithstandi hg any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home �'r�Ir
that'•not assessed as real property or to a manufactured home that is not assessed as real property may 4 I3'16' -
not -: -•one-half(12)of the assessed value of the mobile home or manufactured home.
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DISTRIBUnON:Orf„ial-County A:rtor,Fae-`crud COpy- agayer