Homestead_Wright (10) i�;±t-_.. ' < ._-.,•. `. ' �,,:7 J PROPERTY TAX FORM YEAR
.��( , - , !5i•. :rENTAL DEDUCTION
F�jp�; r• .1 - . - HC10
"„'t/ ,`' �.:n .fiscal Government Finance '
o... OP-
INSTRUCT/Oi- •� - •t fling instructions i•
NOTE:Teleploi.t,, Q r ,driver's license,stale identification end federal ideaWication numbers are confidential un .1- -37. -' s
.: •OERTIFICATION STATEMENT'': ,. _ t- .. - 2.( . frf•1,• PHIt, ' 1
I(we) - -(CJ X L. - Yr certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following"—.'bed real property under contract for which a Homesteadiftter8 Tax Aldard
Deduction is hereby claimed on the date this application is signed, (date of signature). I(W)j.I i
❑ Own. ❑ Am(are)buying under recorded contract I .
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. �e ��
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a r i uel311-"Aib Y5
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. UU YYYR
-
__.
U toying on contract Fee Simple owners name
Remrde?s a-Sce where contact is recorded - I Record number I Page
s'e'w ,=3"f .eat'SP.ROPERTYMESCRIP-TIOITI- r_ tiglri` ? Wi'...ate S�'i_-.'
Cohmb Township I T strict '
Y`'
Parcel number Legal desaia� z - d I Is the property N queriat
yr N ¢N
q. `38 P Real property ❑ Annually assessed mobile home(/c 6.1,1-7)
If any poiton of the residential st'jc ire or the land not exceedfg one(t)ace that immodesty sa-rwnds that Dumas is used to produce borne,describe the use and pordon
of the property V2bed to produce income.
,? - /2 . ;2 - /00 - ooy. 5 ),2 - OIL7
_ PROPERTY OWNED ELSEWHERE BY CLAIMANT _ , _ _
Ste.Can't.and TawsItp Is claimant vaWdng a homestead?
. . ❑ Yes ❑ No
} r..ar¢/
I hereby certify the above statements are true,correct,and oomplete.'X I j�
Address of contact(number and street,sty,Sete.: •LP coda) ,\
Address of vacated toxsteal,4 umber scatreef.sty te.and ZIP code)
A, 30911r / 5S , 1 ` _01 ,4! 417670
•ASSESSOR USE ONLY • ASSESSED VALUE" HOMESTEAD VALUE
I. .NON-VALIUE DENTIAL
not exceeding one(1)acre Immediately (1) — a - -'-7
surrounding residential Improvements
h'-'144'"
Other land 2 ----- - g .-r_
Total land(line I plus line 2) (3) - _ - _
Residential improvements or Dwelling (4) ^t 'tL_ ..�fi
Annually Assessed Mobile I _„�,.� ' -;"
Manufactured Home Garage I(5) • I ''.
_r.:Z__
Other improvements (6) --%-w+.` _, 't
Total improvements(line 4 through line 6) (7)
Total value (line J plus line 7) (8)
I hereby certify the above is true,correct.
Signature of At.wer Date signed(month.day,yea.)
and complete.
Verifying adion-Signature ofAudar ft a•g day, .. 1
'1
r
a Y:JY-Pf;e.t_`- ,'r ss `- '.STANDARD DEDUCTIONALLOWANn `�¢sgy
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000 JUN 3 2016
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
that is not assessed as real property or to a manufactured home that is not assessed as real properly may
not exceed one-half(OR)of the assessed value of the mobile home ormanufalured home.
&lgratre of Auditor Dab signed
0 ) . ,�,,,_ •_ za, / GIBSON COUNTY AUDITOR
DISTRIBUTION:OrigiW-Co_nty Ad:No,Rave-Samped� d CLopee--TTas ay r