Homestead_Allen (6) ,' CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
t.... ......,--: STANDARD/SUPPLEMENTAL DEDUCTION FORM -
stra Rem 5173 0,07/1-16)
Pre W,Oed by Ce DepamvG a lnd Govanoev Fai[e 11010
INSTRUCTIONS:See reverse side for Sag instucfons
NOTE Telephone.Soda)Securfk drivers 6rense,stale iden55cs5oa and federal)dn>idcafm numbers are ro atS!isnler'IC 67.14247.
I eArs) certify that I(we)occupied as my(ow)principal
place of residence Cr am(are)buying the following descnbed real property under contract for which a Homestead Property Tax Standard
Deduction is hereby clamed on the date this apphcugon is signed, ' (date of signature). I(we):
❑ Own. ❑ Am(are)buying under recorded contract.
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial irteresi in the trust or the right to occupy the property under the terms of a qualified personal residence bust
❑ Am (are)the shareholder, partner,or member of the entity that owns the property.
,
Carey Tamakp Taury aaid(atyc taut amslop)
Patel ruarme tags descoptcn Is PO Plapely In psstiwt
❑Real ROPety ❑Maus%amassed mob.*turn(IC 61.1-7)
II any porrm of ee readerta1 strodtre a by land not eorahg ore II)ace that mmeatey want em etumve is used to prance some,desote the use and pgnen
of tie;speedy wised to podse from
State.Casey,aid Toenship Is claimant vacating a homestead?
❑ Yes ❑ No
SQ cored•
I hereby certify the above statements are hue,correct,and complete. • C
.. _-dwnbd(rembe'er sae, Peona) // /•7 'n-. drambd ,tom.Reny Vvmdeand meet,city.Nab.end Z/Pmde)
y`• _ sE _ I • f T' -' -` `z' NON_RESIDENTIAL
•F ASSESSOR USE ONLY t .-_� I ASSESSED.VALUE.,-...I 4-H061ESTE4D VALUE _ i,ygLUE at:�rt.
land not exceedingorm(1)acre Immediately (?) .3 p'.__. .,-- _ '1'
surrounding residential mnpswemenb . . -_ ,.>
Other land 'Itk?:= .°4.23.,<>;.a
Twat land(line 1 pies one (3) JL •„ -
itasidendal Improvements w OweOrry (4) �j ti: -r.;..
annually assessed mobile I
manufactured home Garage (5) sr .4 2:[ x. -I
Other improvement (6) "`?"z'1'E.4.L. e,yaf t..,- 2018
Total improvements(fine 4 through rte 6) (7)
•
Total value (lbw 3 plus line 7) (a) , a
I hereby certify the above is true,correct,
Signature of Assessor '11 Tim -e('�:.'f►4i-•(morel d ywar)
and complete. GIBSON COUNTY AUDITOR
Valffrg atim-SimWaa ofAudor Dam signal(man day.war)
°!r: ,.r. f + i_i ,. _-... -:".STAND4RD.DEDUC PON ALLOWANCE r `. :r Itr ra... I. :A.r v. c...
20 pay 20 Lesser of 60%of the assessed vote of the homestead or 515,000.
NMxNStanffig any other provision,the sum of the . provided in IC 61.1-12 to a mobile home S
flat is not assessed as real property or to a manufactu home that is not assessed as real property may d not ete ofauas, of�vaero'.rthe hero wnaradacbard home.
game dAUda — J U Dalai signed(mKA day,VLJS_
DIS1RISIJ lON:Original'Casey ASaor,Ro-nanped Copy-Taxpayer
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