Mobile Home_Welch CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
.•j;s?�: FORM
STANDARD/SUPPLEMENTAL DEDUCTION
yI '4:r State Form 5473(R13/12-09) HC10
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
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I(We) VW,/ Ill" ' . WW1 :7y 41, we) i. W my(our)principal
place of residence or am(are)buying the following described real property for which a Homestead Property Tax Standard Deduction is hereby claimed
r contract on the date this application is filed, (date of filing). I(We): MAY 9 2014
Own ❑ Am(are)buying under recorded contract
El 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 trust
❑ Am(are)the shareholder, partner or member of the entity that owns the property. GIBSON COUNTY AUDITOR
_ - T" . CUUMANPSjINFORHATIONK'7", —4:!!- ,r".'So -;. .c"':,F, Y :?`,' Ys *'''zy`,::
Name of claimant's spouse(legal name)
Social Security number of claimants spouse(last five digits) Driver's Ocean/Identification I Other number Issuing State
of claimant's sprwnqn(fast five digits)
vzu�-.4iA,Watie "•a.. . . #3S7" let i I' .s
.•`CF•�"�Sues.... �..y& �, .; '—CONTRACT RECORDED
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
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i's..a-,a,. . ` .'t t' ` f t pic:' WS PROPERTY DESCRIPTION"'',7 .ro4i y ,c.c __ xa.t" _ A �t'StsST, d ' < :tk.;'.,
Coun Township Taring district(city,town,township)
I number / Legal description Is the property in question:
v Q qoo/(p—i.0 ❑Real property ually 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 is used produce income,describe the use and portion
o
properly
utilized to produce income.
't' 34 *2 t cat S l '`3PROPERTY'OWNE0I BYBY C117M.KT'INiOTH ER7OUNTIES'-" Se(:)v ip y r`(ai a...Y',nt'e
County Township Township
ijillIllnnB
I hereby certify the above statements are true,correct and complete. i� , ,
•dress(number and street state, 27)code) ,Q�4 �V /
may:'- a- 7,'--t i'� `i''i='i ry:Tr'--:--",,`-'' = --'ASSSSED VALUE.,rawsMESTEAD ,3-4 Z-NON RES(DENTIAaik,q.
rs�` z4'',�c" ,�ASSESSO USE:ONLYp• �,i1 RUE TAX V� AL'UE"INATr:1001a OF.ITTV.;F-.n(VAL•UE:"Vbal -t VALUE < xv ux_
Land not exceeding 1(one)acre immediately (1)
surroundin! residential im•rovements.
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Other land (2) —" s- '�,
i
Total land(line 1 plus line 2) (3)
Dwelling (4) 2,-.' w `
Residential obImis/ ementsManufactured
or Ho Annually -- z•.' s _. „r 13.1_
Assessed Mobile/ Home Garage (5) '" . .,
F
Other improvements (6) ';" >"-; -'` '•-
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8) --
I hereby certify the above Is true,correct, Signature of Assessor Date signed(month,day year)
and complete. I - -
Verifying action Signature of Auditor y (1 Date signed(month,day,year)
�`�c?a jAk11"+ '-„tqL-it ` �' '\ rt' ''W':STANDARD'DEDUCTION ALLOW ANCE-+_'' s.. x 'g:+ifil ».a„sx-;4,i'c<rs t z -d.4
. 20 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-I.1-12 to a mobile home that is $
not asse •as real property or to a manufactured home the/is not assessed as real property may not exceed ' '
one-half d )• the assessed . of the ,...• home omen ,, ured home.
nae.' .4.111111171111111.111.11111.1.11
—Date signed(month,day,year)