Homestead_Zimmerman"'" CLAIM FOR HOMESTEAD PROPERTY TAX YEaz
ld,. _ = STANDARD / SUPPLEMENTAL DEDUCTION H RM
Sta;e Fortn 5473 (R12 /6-09J
•�O � Preun6ad by tha Depanmeni ol Laal Govemment F�nce �
lNSTRUCTIONSr Snw rwvarsw sidu /nr filirv� inernic�innc '
�
1(We) ceN t I(we) ' as my (our) prindpal
place of res' ce or am (are) buying the following described real property for which a Homestead Properry T on is hereby daimed
under Vact on ihe date this appliration is filed, (date of filing): pIBSON COUNTY AUDITOR
I(We) own ❑ Am (are) buying under remrded conVact
❑ Am (are) en6tled to occupy as a tenant-stockholder of a cooperative housing corporation
� Have a beneficial interest in Ue Wst or [he right to occupy �he property under Ne tertns of a qualified personal residence Wst
•• . �
Nam imant (legal name)
Sodal da'vriani (bsf frvs E.g3s) Orivers fzense / IdenVfration /
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Name of daimanYs spouse (legal name)
Sodal
. .-� �
II buying om m�tract, Fee Simple amefs rume
Reootdefs oKice where cmtraG is recordeE Remrd number Page
. _ � . _ � . �
counry rownsnip rawy eisvia (c+N. rown, tok,.chrp) '
a n mher L al tlescripUan Is Ne property in Qurstion:
6� + ��� �� � � Real property � MnuaOy assessetl rtndle home (IC 6-7.7-7)
�It any portim of the residential swcwre or Ne W�M na ex ug rne (7 ) acre that immeEiatey wrrounas that swmre is used m proeuce i+�arne, Eescnbe the use anO portion
ol Ne pmperry utdQeC b pratluce inmme.
� N � N� ao-3-I� �o• �4c.
-.. . .: . .
Counry 7ownsNp Counry Trnmsttip
I hereby certify the above statemenis are we, cortect and complete. Signa�u f aaimam . � �
Address (number and s1 t ciry, stare, eM LPaotla
v ��a
,_ , , . .. . ,
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Land not ezceedin 1 one acre immediate ` Y:+`"�+ 3 ���k.°S .c'"f �"' �`�=
9 ( ) �Y .+ ��'r- � ..�,
surtoundin residendalim rovements. (�) -;.:�"�..::i�•_:�,i:�c-: a�.=-s°ST°>-sr�:•:
y`�^,�+v_-`.>�i.��.%.(�j',�°_+:� .
Other land (2) • �-.,,'�, �-.g�'_�-,y;.,xt^� _y. • '
Total land Qine 1 plus line 3) (3) '
tk�'l�'�...+ �.q�V� �c:S�T
ResidentlallmprovementsorMnually �8�1in9 (4) 4- � �,��;q.�,.� ,-;',xd,�-,
Assessed Mohile 1 Manufactured Home Ga2 e + f='^+s� ;✓' '�' ���+ ��F ��.
8 is) tf b: :r.>.a� _s�.�w'���a�%5� �'
OUer improvements (6) '��;.<z?s ��%S',.`.��3:'.
7otal improvements (line I througn Itne 6j (7)
Total ralue (line J pl`s I/ne 7) (8)
I hereby certify the abova is true, correct, Sig�ature otASSessor Date signed (monm, day, year)
and wmplete.
Verifying action - SigriaNre oflviditw Date signeE (rtronN, tlay, yce�
�.-� � � • •
20 pay 20 _ Lesser of 60% ot the assessed value of the homestead or 545,000
NoM1UifASlarMtrg eny atherprovision, Ne wm ol the deduclions provided in IC 6-7.1-12 to a rtro6de Mme Naf is 5
rwt assasseC es ieal propelly or to a manNaCUred hane that is rwt essessed es real pmperty may rwt exceed
one haH(1/2) W Na assPSSetl rdlue a! Ne mobda hwne or manulacturetl Aome.
Signature of /u#itar Date signeC (month. tlaY. Y��)