Homestead_Longest • .� .. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
rf STANDARD/SUPPLEMENTAL DEDUCTION
Foy
r o/.- Sae Fan 5473(R17/1-167 HC10
Razaioed Pr the Department or toatl Goverment France
INSTRUCTIONS:See reverse side for tiring instructions. t
NOTE Telephone.Social Security Theta icense,state tiff5ca5on and federal idnttircabnn numbers are confidential , •-(g• 114(a 7. I_
CERTIFIC 4110t4 STATEMENT
,�1
I(µp) ant - centrY that I(we)occupied as my(oat)Pritldpal
place of residence or am(are)tdlylrg the following•>: .-.real• w- under contract for which a Homestead taty
Deduction is hereby claimed on the date this application is signed, (date of slgid8l1@). (' e v
❑ Own. ❑ Am(are)buying under recorded contract.
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. I - •i
❑ Have a beneficial interest in the trust or the tight to occupy the property under the temis of a 't °�splt.
❑ Am(are)the shareholder, partner, or member of the en that owns the
my property. GIBSON COUNTY A DITOR
Carry Township Taxing*Isola(ray,urn osmsfp)
Parcel meta Lego/totem its Or property in aaLaa
❑not pogaty ❑Annually assessed motile rase DC 6-1.1-7)
It any pane d ea m_sldentw senta a the lad not etteedvG an(1)aae gat hmmre raely smut that annum is used to produce morn.tate the w eM gallon
d to prpesy lamed to pits hula
(9L. - i8-31,- woo-coo . 8' la-_xq
S.s 'a: s....a.. . .x£c......:''PROPERTY,OWNEDECSEwHERE.BY•CCAlwA6'T t. 2- '. .7,7„;,
5bo,Cady,aM Toanshq Is dalment vacating a homestead?
❑ Yes ❑ No
n r 1
I hereby certify the above statements are true,correct,and complete. t�
A4Ness of mNad Ownerard...- dty,stay,and EP axle) a'matted M'mbA{(anyvaet . ......cam shoe end ZIPci.)
1k) ■auJ. w .3%
ASSESSOR USE ONLY I �ASSESSEO V0.Ll1E ._f HOMESTEAD VALUE __ I '_ NON-R S DENTIAL _
Land not exceeding one(1)acre Immediately ltl chc?�._1 lgT
ndmg residential Improvement ._..,
Other land (2)
Toth land(line 1 plus One 2) (3)
Residential improvements m
Dwelling (4)
annually assessed moh0oI
manufactured home
once (5)
Other improvements (6)
Total improvements(lme 4 mragh line 6) (7)
Total value(line 3 ohs line 7) (8)
I hereby certify the above is true,correct, Sialaaae of Assessor ode limed(mask tX yea)
and complete.
Veayng amen-Signsre of Meths Date waned ftradt day,lea)
^�-_ _ „m.?b;{ S .;y_;� _ T,STANDARO DEDUCTION_FLLOWnNCE.' t r-. ,.•.-:. - ,'�v x_. ' f,)
20 pay 20 Lesser of 60%of the assessed value of the homestead or K5,000.
Nototthstancring Nat any other pmlaon,the sum of the dedlt'onsproNded in IC 6.1.1-12 to a motile home 6 MAR 2 9 2018
property or to a manuraWred home that is not assessed as real properly may
not exceed al(1/n aftM assessed value of the mobile home or narudacgred home.
.ea 1 Dete a
mSTRasunoN:oil gruel-caayama,FaasanpaaCopy-Tapley. GIBSON COUNTY AUDITOR
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