Homestead_Woods Q44 CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
- STANDARD / SUPPLEMENTAL DEDUCTION FORM
-- State Form 5773(R13/12-09) - HC10
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Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for tiling instructions.
/1 . A
-, which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing). I(We): NOV 1 0 2014
❑ Own ❑ Am(are)buying under recorded contract
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation ///'''
El Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified person
DI Am (are)the shareholder, partner or member of the entity that owns the property. GIBBON COUNT AUDITOR
's-: - '_ � . .�£ .�.:: . _.+:. x`-ft -.CLAIMANTSINFORMATION' :� _ , '-_ s.•:..--hT 's: _t;: � ' -� .... . .
• _ - - -
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
=_: :n i. 1 . . :.-- _ -.j-; PROPERTY DESCRIPTION
cou ,1 Township Taxing district( o o hip)
li �� fl 0i. • .is t-1_
r/ye_I n r a(� �iry� Legal description! Is tthheproperty in question:
tD C 'T w�0 aq S Co-0 a I xi Real property ❑ Annually assessed m•:l ome(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
- - ,.. ,j ' ` PROPERTY OWNED BY CLAIMANT IN-0THER COUNTIES - -, .:. :::.:-,
County I Township County Township
f;',„/
I hereby certify the above statements are true,correct and complete. S-ignature of claimant �� q �t�
Address(number and street,c i t y,stab anZIP code)_ �I L� !iL/�7JYr-
I . • 7 OA GS
ASSESSOR USE-ONLY ,^I.TRUE TAX VALUE-I 'AT.100°E OF TTV.-I .H�-VALUEAD I NON- VALUENTIAL '• -
Land not exceeding 1(one)acre immediately ,
surrounding residential improvements. (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Dwelling (4)
Residential improvements or Annually
Assessed Mobile/Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
STANDARD DEDUCTION ALLOWANCE
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home that is $
not essed as real property or to a manufactured home that is not assessed as real property may not exceed
one- all 1/2)of the assessed value the mobile home or manufactured home.
S' natu Auditor, ��pp Date sign ( nth.day,year)
' !liL ,IVY r 10- I v
�� 3 4 CLAIM FOR HOMESTEAD PROPERTY TAX _
s��;; CREDIT/STANDARD DEDUCTION
�„�.�;' Sure Porm 5d73 (R2 / 5-92) �
,.,.
INSTRUCTIONS: See reverse side lor liling inshuctions.
�C�� YEAR
NOU 0 6 1997
- - CERTIFICATIONSTATEMcrv� -
G!BSO�!CO(IhiTY ;!miT�1R
I(We) __ certify.ihat on the 7st day of M3rch,'79_
) occ d as our principal place of resi nce ihe follo �i described real property for which a Homestead Property Tax Credit is hereby c�aimed:
I�(Wewned
) ❑ Are buying under contract
❑ Have a beneficial interest in ihe entiry ihat is liable for the property taxes on ihe property and thal owns ihe pwperty or is buying under a con,ract.
- � • � � � � CONTRACT RECORDED � - -
If buying on conVad, Fee Simple owners name � "-'
Rerqrder'S oftice where ConlraCi i5 recordetl Record number Page
County
P In�
If any portion ot Ne resitl
of Ne pmpertv utilizetl to
`�' PROPERTY DESCHIPTION " � � -
. Township T�inq district (clry, town, rownship) "�
� Legal description
S ��5=3-13 `��I/�L.
swaure or the land not exceetling one (1) acre that immedatey surrounds that struc[ure is used ro produce iricome, describe ihe use aM portion
iceincome. . _. .
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County TownShip Couniy
-�eby certify ihe above statemenis are irue, correct and COmplete. SynaWre of claimant
7i � ✓
Address (numberandsneeG ciry, sfare, ZlPmde)
-- GP Z � �i �c �/ 3
ASSESSOR USE ONLY
Land not exceeding 7(one) acre immediately
surrounding residential improvements.
Otherland
Total land (line 7 plus line 2�
Dwelling
Residential improvements
Garage
Other improvements
Total improvements (line 4 thiough line �
Total value (line 3 p�s line 7)
I hereby certify the above is true, correct, and
�mplete.
Yentyirg action - SignaNre of Audimr
79_Pay19_
Lesser of 7l2 Homestead
Valuation or 52,000
TRUE TAX
VAIUE
(�)
I21
(3)
(4i
(5)
(6)
(�)
l8)
ofA55e55or
S
ASSESSED
VALUE,
ALLOWANCE
HOMESTEAD
VALUE
0
NON-RESIDENTIAL
VALUE
Date signed
Date signetl
o� Auditor � I Da;e signed