Homestead_Hamby CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
c i; STANDARD/SUPPLEMENTAL DEDUCTION
State Fenn 5473(91711-16) HOW
Prescribed by the Department of Loch Go.nnav Fea da
INSTRUClIONS:See reverse side for any instructions
NOTE Telephone.Social Serantv drivers license,state iden65arcn and federal identification numbers am confidential render IC 6-1.1-12-37.
I(We) a certify that I(we)occupied as my(our)principal
place Of a (are)buying the following d property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application 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 interest in the trust or the right to occupy the property under the teens of a guar • -•`.,
❑ Am(are)the shareholder, partner.or member of the entity that owns the property. . I for
_ . . CLAIM NT'SINFORiAATION":. :7rr7Yl illkk4 r'^•' r
Pane dern peril ,_- •
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GIBSON COUNTY AUDI—OR
_-, — r - • ;' )
e doing on mlract.Fee Simple oases cane
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Recorders Mice scam mead b racceried Read ranter Pape
. _ PROPERTY DESCRIPTION •
Carey Tonvtlp Tag dstrs(all:tovn.llrmNp) I� s `^' lV' 1
FT
Paul amber Legal deadpan Is it prtyify n gteseda
.Vl,^d/Red Frugal ❑Annually assessed Mebie home(IC 6-1.1-])
It any port=of to re daeid sbudaea the teed not eaeetg ae(1)acre that mmetaeN slamMs that:bums is used to Ream Memo Matte to use and IerWn
elite property MGi¢ed b aodale Income.
2.6 -1q - 1 S -304-000.36 —026
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PROPERTY-OV✓NEOELSE:"MERE BY,CLAIM,ANT„
Sum,Carty,ad Tanet✓p Is claimant vacatlnp a homestead?
❑ Yes ❑ No
I hereby certify the above statements are true,correct.and complete.
x6Zgaft
Address el oxtail(number and:bees ads Pep and Zecccb) Address rimmed haimslml.a any Wns:m cal and ZIPcods)
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ASSESSOR USE ONLY _ -) ASSESSED VALUE��p=yl -HOMESTEAD VALUE . N0,!-REASIDENTIAL
Land not soneuriding resresidnti l Improvements any` (1) �4 Pi,. a ?,t 2T;IT: e
Oder land (2) `.c
Total land(line 1 plus One 2) (3)
Residential improvements or eweminp (4)
annually assessed mobile/
manufactured home Garage (5) r..'<G,lit_4» x. , ?--rn
Other Improvement (6) r'r1 rs
Total improvements gine 4 through line 6) (7)
Total value pine 3 plus line 7) (6)
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Oro hereby certify the above is true,correct, '°e ctAssassa a ( A&Y )
and complete.
verifying=don-Slpnsne of AUdbr pals Arad(nvrlt4 day,yea4
�- - "'STANDARDDEDUCTIONALLOWANCE'r-+ - .. . -
20 pay 20_ Lesser of 60%of the assessed vaue of the homestead or 545.000.
Noiwfthstandi g any oterpmvisior4 the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
that IS not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed one-hat(VW of the assessed value?E )home or mantdacraad home.
Staab,.dAusEdr Sh°A Tn\ � Deed eel m�,rry1<t14 mYy.
WSIRBUTi0N:Original CareyAUP.a.IisSaiped Copy-Taxpayer
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70i— F \)ern C-\-- Pape 1 of 2
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