HomeMy WebLinkAboutHomestead_Neier 4,-�-)„ CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION Eli'
BUs Form 5413(DePa S1Q _
Prescribed bl the Dep aNnaa of Local Government Finance
I
INSTRUCTIONS:See reverse side for filing instructions 1
NOTE:Telephone,Social Security,driver's license,slate identification and federal identfication numbers are confidential under IC& -12-
- - .-. r- .t. .t(1�. z_..� CERTIFICATION STATEMENT,'4: ;5:...'_'_.q 7T,.."..o.y:;°--;^:.•). ''':'::::1'.'!:..
I(We) rt s� ,i, s 11 certify that I(we)occupied as my An a• 117
place of resider)...or am(are)buying e following described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, (date of signature)./p(Wa);
Own. ❑ Am(are)buying under recorded contract
Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. GIBBON COUNTY 4UDITOR
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
❑ Am(are)the shareholder, partner, or member of the entity that owns the property.
_:
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If buysg on contact,Fee Ssnpte owrds came
Reorders oice where contract is remntlen Record number 1 Page
-+5°." =ga`.-' - ti4ett'a;AWA" iaMPROPERTY;DESCRienoN ?r-4"�yv
Cloy
Township Tang ds}id(cityWWI,tOMT{ML11)
a �ty
Parcel number �y/� Iv.Legal description Is the pmpeny in ques iorc
en 43-c/4',01.c N-b✓t , S J b a 1 Real POperb ❑ Amrmty asssed motile home(lC 61.1-7)
l any porton of the residential svuci e or the land riot exceed:GI we(1)acre that h:rne ally surrounds that sbuS.ae a used t'produce income.describe the use and por
of to property stibed to produce income.
- PROPERTY OWNED ELSEWHERE BY CLAIMANT _ -
Sxe,catty,and Township Is claimant vacating a homestead?
. ' ID Yes ❑ No
Sgru:ura s dal
I hereby certify the above statements are true,correct,and complete. t
Address of contact(amber and&rest coy.Mate,and ZJPm]e) L476 1 C Ad of so homestead,. (nub uE.Ccet,Ly sate,and ZIP code)
i S Wr r243 • .k R aoT Om klr
ASSESSOR USE ONLY -I. ASSESSED VALUE. I .HOMESTEAD VALUE , • I NON ESISIDENTIAL 1
Land not exceeding one(1)acre Immediately I(1)
surrounding residential Improvements
Other land (2)
Total land(line 1 plus line 2) (3) - _ - _
Residential improvements or Dvreigng (4)
Annually Assessed Mobile l
Manufactured Home Garage (5) I
-
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (6)
I hereby certify the above Is true,correct, I Signature of Assessor Dam m
and complete.
Puttying anion-Signature cdAud'.tor Date si ( N, y, 'D
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__ `°-":?'_'-°"' "'j'¢e?=-�'ey'STANDARD DEDUCTION'ALLOWANCEL -A -t,-T(ti oa t e
20 pay 20 1scn, of sum of the assessed spreidtd i IC6-11-1ar5a mobil
Mat is assessed any d as property the Samafuthe turgid deductions that is not assessed es eda cal rope home S
likem-eviztittk
Nat Is not assessed as real property or to a value of the coo home that is not assessed es real property may
not exceed one-half(12)of the assessed value of the mobile home or manu.SGrrrad home. f !
Signsrre at AX110( Otte GithSOldp .OMN I Y ALDITOR
C]l G S`Sl`� ��]_J'(�-+-/�-� LAIN- Li"-e -1: .- I 1 •
DISTRIBUTION: Original-Corcy A:#3r,Fie-Sa ped Copy-Taxpayer