HomeMy WebLinkAboutHomestead_Edgington ,�� ;, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM •
State Fors 5473(R15/5-14)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filling insbuclions. •
NOTE:Telephone,Social Security,driver's Lcense,state identification and federal?dent-I:cation numbers are confidential ••a le'. 11 12-3
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:-•. 'r .1-•... .. ..'-'_.4 _ . -�,v CERTIFlLATIONST ATFEENT .P ��• . _ t.� ZP }� I- ••I,FIST'4 4
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I(We) g /- L .. •',e .
it: ..D certify that I(we occupied as my our principal
place o r- idence o f m are)buying •-following• •'b(real property under contract for which a Homestead Property Tax Standard
Deduction is hereby-aimed on the date this application is signed, (date of j tu2)4 ail
❑ Own. ❑ Am(are)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified st .
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. GIBSON COUNTY AUDITOR
If bag on rauac,Fee Simple owner's name
R!mt&s o a where mead is recorded (Record mcnbr I Page
;.c°$v s>k a? •P.ROPERTY;DESCRIRTSYNT, _ 60,?i
County Township 1 Tsrvng jr-(m11',town,teems/40
Parcel masher Legal desaiption III Is theN�-/•purtY Mqu a
❑Real property ❑Annually assessed noble hone(IC 6:.1-i)
If any Fatal of the resider al stCre or the land not ex •-y one(1)acre that irrnecrasry surrounds that rivnne is used to produce income,d the the use and portion
of the property ash ed to produce income.
a6, -Ds-33-100- ED 3e Ess- oaI
Oats.County,and Township Is claimant vacating a homestead?
❑imYes ❑ No
amSignstire I hereby certify the above statements are true,correct,and complete. 3 [c
m of contact(nanber and shad,city,state,and ZIP code) Address Of vacated homeslwtl.L 8th(number and suaef,tel:stale.and ZIP code) .
Co75. Dun/4 b . Pr . ■ 474 6
Land not exceeding one(1)acre immediately (i)
surrounding residential improvements
Other land 1 (2)
Total land(line 1 plus line I) (3) - - - - _ ____. _
Residential Improvements or Dwelling (4)
Annually Assessed Mobile I _
Manufactured Home Garage I(5) _
Other improvements (6) • -t--` . _ '�
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) 1(8)
I hereby certify the above Is true,correct, (Signature of A=usw Date signed(month,day,year)
and complete.
Ve yvg action-Signature ofAud:a Date signed(made.day,year)
n..= : -=.-sSTANDARDDEDUCT1oN1AL'LOWANCE EM -', gro -r-. `=-." y
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notnithsandmg any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home S
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed one-half(12)of the assessed value of the mobile home or manufactured home.
ol(/FE / /�y�/'� Oab signed(rsae•1 daY.YaM
015TRISUTION:Otigtal-CountyAud..d/ Taxpayer