Mobile Home_Johnson CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
(atilt. -. STANDARD/SUPPLEMENTAL DEDUCTION M kA/F O
c ' State Form 5473(R13/12.09) HC ;I)�
'mot" by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. FEB 24 2012 _
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I(We) L%��Li1 11 � �ii I ✓/i p certiN fat I(we)o� as my(our)principal
place of residence or am(are)buying the following described real •perry for which a Homestead GIBSON COUNTY AUDITOR hereby claimed
Set contract on the date this application is filed, (date of filing). 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 terms of a qualified personal residence trust
❑ Am(are)the shareholder, partner or member of the entity that owns the property.
• :;Dt _-,:t in ex; ia� w`r' C IPAANTSiINF.ORMATION;.t 2=1-`*.tiiid:s},a gi ro'.-..- ,?t` a, f7°t; t .
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Name of claimant(legal name) C Q 1
Social Security number of claimant's spouse(last five digits)I Driver's s license/Identification/Other number Issuing State
of claimant's spouse(last five digits)
-•+x tL.1>"+ r'. a 9is iY.r: ..it 2 'CONTRACTeRECORDED,, '•_ £i A,E;t`K ,'�{.`'�.`.uZ,ffsen,..a :igt .,,. $;;I:, r.
If buying on contract Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
�ait-_ ..4 . - µ:€:c r4i-: falY 2PROPEFifk.DESCRIPTIONk vvaz.t'ir <,Aa+ ellY4T I2 iigi. •< S
County
Township Taxing district(city,town,township)
-
Parcel number // ❑
egal description I Is the property in question:
ii� //6ja an234 Real property tally assessed mobile home(/C 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)ace that immediately surrounds that structure is used roduce income,describe the use and portion-- —J^
of the property utilized to produce Income.
n.`..-�.,��..q7*.y x.- yac'h,yr?"�:iimPROFERTY,OWNED,BY CLAIMAfvT;:IN OTHERCOUNTIEStjjyi{.,4tryti,,,�a`gC:W'S'+,i�WZ.-_:;,,lia
County Township County Township
e
I hereby certify the above statements am true,correct and complete. S'natua'f- r .nt
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-n . x:'i..e s- 'Y x "Ye T"tsi.fa. - ,--,-; , ASSESSED VALUE I HOMESTEAD �-t NON RESIDENTIA(j i `3'
d.r n}. ASSESSOR USE ONLY !�<,€ni sa(g.TRUy E)T VALLUE t t.,AT.'_10010 OF TTV.!�. _a+VAL'UE,3.`�.t. c 1 VALUE e W n<'
Land not exceeding 1(one)acre Immediately YT y ' i r =p
surrounding residential Improvements. (1) - - E * " '�- - •
Other land (2) ..,,,i.--:-••.-Al, ,."`y<,F;..
Total land(line':plus line 2) (3)
Dwelling (4)
Residential Improvements Annualh/
Assessed Mobile/Manufactured Home Ta" ' ,
..s 4_
Garage (5) ra4C . y ,
d ;. - . • .rr
Other Improvements (8) .. y= (
_- f
Total improvements(line/through line 6) (7) 2
Total value (line 3 pits line 7) (8)
I hereby certify the above is true,co \
Signature of Acseasor Date signed(month,day,year)
and complete. r�1.,' /
Vaifyi g action-Signature of Auditor \, \V \I \'.J \'`\Q ` \k `% Date signed(month,day,year)
'jr`,"2 o?;1.CPs1::41, ?02&—:1LY.r4 M-v5:rigti:.t,,:S k11:liRD;DEaleTIOkALLOWANCE„P"'I-,4,AVri,STL 'qu >'r2:a414)1,(.?-^: .3g.".C. t);
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
i
Notwithstanding any otherpovision,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-hall 112)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)