Homestead_Robinson ec 3CLAIM FOR HOMESTEAD PROPERTY TAX - YEAR
g. STANDARD/SUPPLEMENTAL DEDUCTION FORM
- '- Srm Fan 5473(R17/1-1e) HC10
Prevted tote Depatrnel of Lod Ganthroent Fes®
INSTRUCTIONS:See reverse side for Pang nNUctona
NOTE Telephone,Social Seaaf%divest license,state abrarbar.5 t and federal l*rfficabon numbers we m>Sdential under IC 6-1.1-1237.
• }�r CE�RTIFICA�TION STATEMENT
I(We) -a � 1 eIar 1/ A. 4, Al certify Mal I(we) Yaa).,.y. :.r
place of residence or i (are)buying the • • ..described real property under contract for which a • __,; P -} �t: Tax-..:PT'.;
Deduction is hereby.-;nerd on the date this application is signed. (date.. .., .•7!1. ,- �'
Own. ❑ Am(are)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. MAR 9 2018
❑ Have a beneficial interest in the trust a-the right to occupy the property under the tents of a qualified personal residence trust.
❑ Am(are)the shareholder, partner,or member of the entity that on the property.
Carey Tavnsm, •Tinto (ay, loelah4)
Pond renter tens desa*r:m Is the pvpaly n quetiat
Saud Pr Paty ❑Annually assessed noble hart(IC 6-1.1-I)
If any pram of the residential saucers a rte land not earete9 me(1)aae that'mmediAer=ands that suumre is used in produce Income describe Or use aid carton
of ere properly tared n praise income.
2 - Z0-6 06a, 7/5 —Gay
s 1,,PROPERTY,OVdNED E&al ERE'BY,SLAIh iriF c'rr."7. ' �_-
sae.Carry,aid Township Is claimant vacating a homestead?
9 Yes 0 No
Square of Omar
I hereby certify the above statements are tone,correct,and complete. X � I-���
Address of aaean(neater am/sine[ace sate.and ZIPade) Addressd noTes>Dad.cap( nbartai:beet M:S and ZIPcod)
/ W :.a _ „ / /I- ,i, .y
ASSESSOR USE ONLY --I - ASSESSED VALUE �4` HOMESTEAD VALUE .. .NOt!_R SIDENTIAL:'
Land not exceeding one(1)arse Immediate y X":. 6-x 2E;3 Z'K 1 F as °2`
surrounding residential improvements (1)
....;.,.,
Omer land (2) 3 x'�....ra>;`;
Total land(line I plus line 2) (3)
in::.'�:t"- .sue 1._r•-
annually assessed mobile Dwelling (4)
manufactured home Garage .''.-;•yi.:-v �':.-.
Other improvements (6) _.;...—.s• _;:<.�n.+::.
Total improvements(line 4 through Gne 6) (7)
Total value (line 3 plrs fine 7) (a)
I hereby certify the above is true,correct, Square dAssesra Urn m 1 r
and complete. . ° -
Velyi9¢ton-Signalise cfAt
.t- '',11.-;4.. ;C '- STANDARD DEDUCTION ALCOWANCE
20_pay 20 Lesser of OD%of the assessed vaue of the homestead or$45.000.
Nobeflintancang any other provision,the suns of the*+(Aurora provided n IC 6-1.1-12 to a nobae home $
that is not assessed as real pmpvfy Brio a manufactured horse that is not assessed as lea!properly may
not exceed one4 at(Ii of the assessed value of the mobile home mmanutacaaed home. GIBSON COUNTY AUDITOR
DISIRSI TSO1t Original-CautyAUia•Re-Sapped Copy-Taxpayer
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