Homestead_Thompson _t"s. - CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R15I614) HC10
Prescribed by the Decal:men of Local Goverment Finance
INSTRUCTIONS:See reverse side for filing instructions
NOTE:Telephone,Social Security,drivels license,state identification and federal identification numbers am confidential u 611-1:37 i
_ .- ,y _., - CERTIFICATION STATEMENT ''- 1 • a` r t NJ!, -'r r - I
I(We) A J _/i .x11✓.f�_�� certify that I(wce)�!w.. as 7.'i�'i....' e4•TION
place of resid- ce or am(are)buying the following de • .:-• real property under contract for which a 4 n� y- f.r transfer
Deduction is hereby claimed on the date this applira5on is signed, (date ofa' ) . I O ____❑ Own. ❑ Am(are)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation, a••❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a • -, ,. r.,cV j/y� e"rlp, t❑�,A�udiit�or�
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. t S i O.1 TY AUtl79VT!ountY
____ _
If bysg on contact,Fee Simple camels name
Recorder's oLce where contract is recorded Record number I Page
,-`4.v` irir'i it;--c -t _._-e P,ROPERTY,DESCRIP,TION Fief-r 3r,W51 .a •T:G`tliO4 i
Cary Township Taaig risaidd Katy,town,tonnsht)
Parcel camber L I d " Is the sty in q
yti
t.�� question:
d- /L /2-- ❑Real property Annuely assessed moble borne(IC 6-1.1-7)
If arty porton of the re idenial tom es a the land not exoeedeg one(1)ace that immedIYlf surrounds that sometime is red to produce income,desaibe the use and nodal
of the property utrme to produce income.
,,,,i6 -l7-aa - %oo -oo $ - 0 /Z. -_o1.7
. _ ',PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sass,Carey,and Township Is claimant varadng a homestead?
. ' ❑ Yes ❑ No
-,f Wenare
I hereby certify the above statements are true,correct,and complete.
of contact(number and sleet,city,state,and ZIP cede) ,dairy(numbaerd Street,oty state.and BR“de)
Owwsu'Ur
%isQ
A �• U •N .I s .1 I .I ., s•s I .INONR SID NTIAL
VALUE
Land not exceeding one(1)acre eats immediately (1) t,'y'�'
surrounding residential improvements
Other land (2)
Total land(line 1 plus line 2) (3) -- -
Residential improvements or Dwelling (4)
Annually Assessed Mobilel
Manufactured Home Garage (5)
Other Improvements (B) „ . ''t`--
Total Improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (S)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,seed
and complete. •
Vestyhg action-Signature of AUdar Date signed(month,day,year)
g- � ,,..4 '-�A.2..7 �'-a'y"BSTANDARD DEDUCTION'ALLOWANCEIg-M'�a:? IjZM ;
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000 i , j
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/alproperty or toe manufactured home that is not assessed as real property may DEC 27 2016
not exceed one-half 1/2 of the assessed value of the mobile home or manufactured home.
Sigrevre of Audior Date signed(month day,year)
:ia_ _S' • i
-grim Tr 0r71rr•
DISTRIBUTION:Orgval-Corny Audtoor.FieSamped Copy-Taxpayer
GIBSON COUNTY AUDITOR