Homestead_Whitehead (9) i We
eriertte.:,..e. FOR HOMESTEAD PROPERTY TAX E
a'
STANDARD D/SUPPLEMENTAL DEDUCTION YEAR
Stas Form 547 (R15/5-14) D
Prescribed by the Departnent of Local Gen/errant Finance • .fm, ii 1 INSTRUCTIONS:See reverse side for filing instructions '^ -
NOTE:Telephone,Social Security,drivers license,state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
' • ^. •a _D , /f��////7'�6CERTIFICATIgN STATEMENT t•-••• - • - 'r17'1.• 1 ,.;vl� 1•
I(We) ,�a agNalI trji.Miff certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real property under contract for which a Homest--•Property ax 1:1•- •
Deduction is hereby claimed on the date this application is signed, (date• ant,, •--'vt.t: -
❑ Own. O Am(are)buying under recorded contract GIBBON COUNTY AUDIT R
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the bust or the right to occupy the property under the terms of a qualified pre sonal residence trust
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
"- -- .:•
If buying on contrail-Fee S:lOe downer's name
Recorders office where contract is reseeded Rend number Page
b.:E• :FC""•v-, -P--r is `Std, - n=A• RROPERTY:DESCRIP.TION _-:•g`3^ - •
Township 1 Taaiagdetid(dry, I/ns,iip)
Parcel combo Legal desolation Is the p question:
cQ t 1
cal Ixopuy ❑AraaaOy assessed noble home(IC 6-1.1-7f
If any paten of the resider-dal st'fln or the land not exceeding one(1)ace that i mmeda;ey that=motet is:see to produce in acne.desalt to use and pork('
of the property Rased to produce boom..
a6 -1a-02- 90a3 - 0D - g94 - Dab• •••PROPERTY OWNED ELSEWHERE BY CLAIMANT - _.-
Stith.Caney,and Township Is claimant vacating a homestead?
///, ' ❑ Yes ❑ No
I hereby certify the above statements are true,correct,and complete. /�1;zn n jU�
Address of (Hum er end street¢x cats,and ZiP Cafe) Address Located homes:sad,4 any(number and street dry.state,and ZIP code)
• G if - i NAB •
•'ASSESSOR USE ONLY I 'ASSESSED VALUE I HOMESTEAD VALUE
1 NON VALDENTIAL ..•••
•Land not exceeding one(1)acre immediately (1) _
surrounding residential Improvements ——
Other land (2) 2. ..v ,•...,..:2-••T
_ .
Total land(line 1 plus line 2) (3) . _ - — _ _
Residential Improvements or Dwelling (4) -
Annually Assessed Mobile! - .tr
Manufactured Home Garage (5)
Other Improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (B)
I hereby certify the above Is tone,correct, Signature of Assessor Date signed(month,day,year)
and complete.
Vedyhg ad'on-Signature oAUd:ta F' I I Dan ,Yeah
N ' '- ' +- STANDARO DEDUCTION'ALIAWANCE`i `�rr {� '- . ��
20 pay 20 Lessor of 60%of the assessed value of the homestead or 545,000 NIT 2 I I
No/withstand/1g any other provision,the sum of the deductions provided a,IC 6-1.1-12 to a mobile home 5
Nat is not assessed as real properly or to a manufactured home that is not assessed as real property may 4 e/
not exceed one-hall(1/2)of the assessed value of the mobile home ormanufacfured home. i 4 r-.AtImIr.
H
synatu. /�� GIBBON i aP .T 1P(9R
•l.) I—OZ
DISTRIBUTION:Original-Coo yaudttor,F➢e-Skimped Copy-Taxpayer