Mobile Home_Fincher ?Ica.. CLAIM FOR HOMESTEAD PROPERTY TAX P
STANDARD /SUPPLEMENTAL DEDUCTION HC10
State Form 5473(R12/6-09) , •. t
Prescribed by the Department of Local Government Finance _ i ti ,;
4 up
INSTRUCTIONS:See reverse side for filing instructions. -
a. • •
• CERTIFICATION STATEMENT
I Me) ittrartorinin certify that I )ocwp' a )principal
place o/dence or am(are)buying the following described real property for which a Homestead Property Tax St hereby.claimed .
under.• tract on the date this application is filed, (date of filing): GIBSON COUNTY AUDITOR
❑ 1(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 terms of a qualified personal residence trust
CLAIMANT'S INFORMATION
Name of claimant( name)
ay (S/L-i . .//,,,/�//L/
Social Security number of claimant's spouse(last five digits) Drivers license I Identification/Other number Issuing State
of claimant's spouse(last five dgts)
CONTRACT RECORDED
If buying on contract Fee Simple owners name
Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township T. .:.. • .T.(dyy, O.•p)
C& Q.
Pa mher f)..5- 6.0-cc)Legal description Is�the-lproperty in ques'
6.— 07 2 Real property Annual),assessed mobile home(IC 6.1.1-7)
® If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure and ure is produce income,descnte the use a portion
of the property utPaed to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township - County Township •
I hereby certify the above statements are true,correct and complete. Signaw t claimant /Z/yt
Address(number and street,city,state,and ZIP code) / c.
05- 5. • . 4 - _! I r //Ce-t a4 ^✓!- `7. 70
ASSESSOR USE ONLY I TRUE TAX VALUE I AAT E00%OF TTV I HOVALUE AD I NON- VALUENTIAL
Land not exceeding 1(one)acre immediately �
/
20 pay 20 Lesser of 60%of the accn ced value of the homestead or$45,000 ///,‘,7,5-----7.&
Notwithstanding any other prevision,the sum of the deductions provided in IC 6-I.1-12 to a mobile home that is $
not assessed as real property or to a manufactured home that is not assessed as real properly may not exceed - - -
one-half(1Q)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year) '