Mobile Home_Clark CLAIM FOR HOMESTEAD PROPERTY TAX / YEAR
STANDARD/ SUPPLEMENTAL DEDUCTION j \J( V FORM
- ,11' State Form 5473(R13/12-00) u V\\ C \ HC10
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Prescribed by the Department of Lace)Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
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w !...I<,,,/..3<::a,.i. �'-��.*:n.. :� ...�'Y ter•.+ `Z�C�+;�s.... ..n.CERTIF;ICATION;STATEMENT�.-:vis,r�._�. r i^m. .t` � i.:.:r �_ r.,:. ,
I(We) Iri%_' WAL_ „e., .. _ _�1. certify th )I we'•.: pi -s ( nndpal
place of res fence or am(are)buying the following described real property for which a Homestead Property Tax Standard D.-..ucbon I - -. claimed
under contract on the date this application is filed, (date of filing). I(We):
NOV 8 2012
�\Own ❑ Am(are)buying under recorded contract
Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation C3
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence t
❑ Am (are)the shareholder, partner or member of the entity that owns the property. GIBSON COUNTY AUDITOR
ciiS roc, 4 i ?A. ` ill41 ' .'`� F_)L`G.xr. tW-`.CL`AIMANT S INF.ORMATIONatw. ..7.°e,y;g i_"��F ,?.�`i,3.��' ._ "y-a':I:.�i�'.14Fcay::k-s'i
Name claimant(legal name) �^
As
.sr: ..
If buying on contract.Fee Simple owners name
Recorders office where contract is recorded Record number Page
R;:iY3^. .s ,tir.._.re . . .. ..�l�.s!-i+<...e�. 4•.>..7`?PROPERT>Y.DESCRIPTION??i3.G"1gr.- kri.0,,*�.�3...,. `.r'+'A,ri 6,-:.=,Z ;b.'>_4^.c,: Lia;
County Township Taring district(city,town,township)
Parcel number Legal desolation 1 Io X & 7 Is the p arty in qu •
'— Ill - o o 5 30-0D 191 ', f Qtti�/'D�,' ❑Real property - 1 J•l Annually assessed mobile home(IC 61.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that Immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilaed to produce Income.
•
+-n, "'f - ,t r s,€ i" 4,r',•PROPERTY OWNED,BY:CLAIMANT:IN OTHER-..COUNTIES `% ;-.�, 'f_ri£ 't
County Township County Township
1 hereby certify the above statements are true,correct and complete. sig re of claimant
- number and t city,state,and ZIP -
4 . y `�Na+ a s ,t t o a • Sol llc 1 N3 4--E • U S
q+ -�:, zo„.x,1 ^ ,- n r - sus R '✓' �'r`i'1L ASSESSED VALUE`ti HOMESTEAD i yHrNON RESIDENTIAL; '
r�w rti '` .x'i- ASSESSOR USEyONLY T ii <_ ley ,1 i8TRUE TAX.VALUE I'AT;100 ro OF-TTVA'1_ P>=VALUE IR~�k.-'-t`s - VALUE -s-$4 ` :+t.:
Land not exceeding I(one)acre Immediately ;c-tiv 1 w''' r .4.:i-.,
surrounding residential Improvements. (1) - � ;_ n'^= ": - -
j ]
Other land (2) x�f' --, „;_
Total land(line 1 plus line 2) (3)
Dwelling (4) f43::;; 1 i4i` t ti x
Residential Improvements or Annually -_
Assessed Mobile I Manufactured Home Garage (5) `\. i * ''cy∎+.7_.r1' '7-a 2.0
.3 c
Other Improvements (6) 1: —g d,
Total improvements(line 4 through line 6) in • 0
Total value (line 3 plus line 7) (8) \ ,
I hereby certify the above Is true,correct, Signature of Assessor \ Data signed(month,day,year)
and complete. �`,Y � \\ VIV\
Verifying action-Signature of Auditor \ r y \I \(� V \I\\` Date signed(month,day,year)
�' w•'`" 5'.:? r,3t'.3tV va I.^` P..sy,I:1:d.r>_VSTrVJDARD DEDUCTIONM—LOWANCE; .44`..4'- si'1-0._KCI''• __s..a,..411 ;(x:t,.e.f'x
. pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mnhiln home that is $
not assessed as real properly or to a manufactured home that is not assessed as real property may not exceed
one-half(1/2)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)