Homestead_Whitehead (2)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
State Fortn 5473 (R6 / 6�03)
Prawibe0 by Ne Departmem of �xal Govemment Finance
INSTRUCTIONS: See ieverse side lor �lrrg insbuctions.
FORM
HC10
�
I(We) �!./�y- � (Q� ��),���pj�� ceRify Iha-t �onrrthe 1st da�y!of March, 20
I(We) occupied as ou rincipal place of residence the (ollowing descnbed real property for which a Homestead Propertyd� Cred�tS�U ereby daimed:
❑ I(We) owned ❑ We buying under wniract GIBSON COUNTY AUDITOR
� Have a benefidal interest in the enlity Nat is liable for the property taxes on the property and that owns ihe property or is buying under a contract.
1( buyinq om m�Vaa, Fee Simple owners name
Remrtlels ofice whaza contraq is
County
L.rid-
�� �,Y ,����, o�
W the properry �
Coanly
Tamship
��v �via oi-�-i� i•���
sWCWre w Ne Wntl not axceeding one (1) aue t0at immeEiatey surrounds
ce income.
%-07/' /�/�'
�==�FROP,ERTY.bWN
ToxnShip
I hereby certiy the above statements are We, conect and complete.
�i:
County
Record number
Pa9e
� Real pmpartyV ❑ Mobila Homo (/.C. 67.f-�
sWCture is used b produce income, desuibe the use antl pallon
Tpvnship
�
� S s , a . _ � �-_ _-�a.� : .-: i.-.:.w. . z;
. -� .. �.('-�'"8�' "
£��^�� ASSESSO��US ONLY ti',A :t j'� z� VAI.UE �� AAT.1 OYe OF TN rHOVAL E�D t� �� iJ VALUENTIAL ��
�: �'*�'..ia•. ...� F�nr.�:l"-..,...t.. ..�Y��
Land not exceeding 7(one) acre immediatety :r ���F"��4 *� �.���..a.�y'
surroundin residentialim rovements. (�) a}'�� `'¢�' �- +�'� ?�'
9 P � ��3.�Z' �'��"� '�'�.,
�� �.t- a.r�r,rx
Other land (Z) ��"���'�. � �
� _'.3��P��'+.T��
Total land (line 1 plus line 2) (3�
�^i<`.� '�i iYrS'a� F 5
's�`�'� " ���r..':�
Dwelling i4) ?.' �-� c;' �,.��
�Residential improvements or Mnually =`��'��*`'�' ' �"�����-��
Assessed Mobile / Manufactured Hane '}'" i���� . � � - -"=`�z"?�''ma �: `
Garage (5) S> .'.#`s" .:'�. : �s;�_. -
�� � i,3�'�-e.. - � � ' '� �-'
.r.•c,.
a�t.t'-N<�:'•'r ��.
Other improvements (6) (j � � �yi%."��� z
r.a:�i-�
TUaI improvemenLs (line 4 through line 6) (7) v � 6
7otal value (line 3 plus line n (g�
1 hereby certi(y the above is We, corred, and Signawre of Assessor Date signetl
complete.
Verilying aclion - Signature of �Wditor Date signed
_�'�� `'�� x� �=,w�<::li���,._ �..,v�.�i i'rs'�-`STANUARUAEDUCTION ALI:OWANCE � c?.%ix�i::.sf4m``��-.'°-�,'�tu�»;•�'t3"�'s+.",�..�'�i�.�i�..��.��
20 _ Pay 20 _
Lesserof 1/2 Homestead
vauanon or 535.W0
5
SgnaNre of Audilor � Date signed