Homestead_Ivy •a.,_ _ CLAIM FOR HOMESTEAD PROPERTY TAX FORM
YEAR
STANDARD/SUPPLEMENTAL DEDUCTION OR
' Sam Form 5473(R15/5-14)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for firing instructions.
NOTE:Telephone,Social Security,driver's license,state'denlification and federal idenffication numbers are confidential• r ' , -37. - :_.
' • ' - CERTIFICATION STATEMENT: }_ _ c . u ) 17' )z' - 1
1(We) `Lam _A .a a . —._. - 1 •1 . * - 1(we ... p' _ • D.' . .F
place of residence or am(are)buying the following described r'- property under contract for 'ch a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, (data of si�ee8 I"1116
❑ Own. ❑ Am(are)buying under recorded contract
❑ 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 pre( st .
❑ Am (are)the shareholder, partner,or member of the entity that owns the property.
GIBSON COUNTY AUDITOR
'
.
If buyig on contact Fee Simple owner's name
Readers oDoe where contract is reseeded • Record number Page
ia, r it;#- 1-`-4-._ a 1,5:':'_:'-A eROPERTY:DESCRIPTION.'- ate- 5e,M -a:-- mow` F 2�
County TovmsNp Taxing der it(atty,town,toonscy)
Pawl number Legal desaip5m Is the property in @rester[
' W P£ ^'-i-3—/D ❑Real Property ❑Mousey assessed mode home DC 64.1-7)
If any path=due residertial=care or the land not exceeding ore(1)acre that immediately surrounds that=rare is used to produce income,desthe the use and porton
of the progeny ud6Pd to produce i ccee.
a4 - 19_ a., y - ,t0o -000 . 7 70 - o a. 5
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate,Casey,and Trnnv4ip Is claimant vacat g a homestead?
,ya5 y�'�mmn��dd • ❑ Yes ❑11 No
I hereby certify the above statements are true,correct,and complete. rated r////
Address of mnari(number and street city,date,and ZIP code) ' Address homeseed,E any(number and sae•and ZIP code)!
K S/ 3 f • 0 S F) h nto L i• r.,
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I .NON EASIIDENTIAL •
Land not exceeding one(1)acre Immediately I(1) - - - -�-
surrounding residential improvements
Other land (2) ,C».._._-«.. +<•.
Total land(line 1 plus line 1) (3) - - - - _ - - --
Residential improvements or Dwelling (4)
.3 0
Annually Assessed Mobile/
Manufactured Home :rill �-r-z
Gauge (5) "_`"a.c�ri-_� --- •s_
..=:a7 :f
Other Improvements (8)
Total Improvements(line 4 through line 6) (7)
Total value (line 3 pits line 7) (S)
I hereby certify the above Is true,correct, Signature of Assessor Date signed(month.day,year)
and complete.
Verifying anion-Signature of Aod for Date signed(month.day year)
"t�'47 -T„- ..=SirIV ..-::: STANDARO DEDUCTION'ALLOWANCE =
20 pay 20 ' Lesser of 60%of the assessed value of the homestead or 545,000
Nofwfthdanding any other provisi n,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
that is not assessed as real properly or to a manufactured home that is not assessed as real property may
not exceed one-half(12)of the assessed value of the mobile home or manufactured home.
Signet=oP Nucor Data signed(mend day,yew/
, .L, , i- /
DISTRIBUTION:Odgial-County NrieT.Fie-Stamped Copy-T
agar