Mobile Home_Wright (3) _ +_>%, CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
F „ 113 CREDIT/STANDARD DEDUCTION HCIo
State Form 5473(R8/7-07) (/ g' "or
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Pre.Kntad by the Department of Local Government Finance
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INSTRUCTIONS:See rawest w e—br filing instructions.
- : CERTIFIC4TIONSTATEMENT .'
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I(We) L( ) /� A, cv Q �/LL$ • certify that on the,ts t day o��March, 20_
I(We)occupied as o principal place of residence , e following described real pro for which a Homestead Property Tax Silt itheacy claimed:
ri1(We)owned ElAre buying under contract GIBSON COUNTY AUDITOR
i .ave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
• - . - CONTRACT RECORDED - -. -
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
'PROPERTY DESCRIPTION. • • • 'County Township Z• - ' (.. .town,.
nu ^,.,i�y egal description sthe pr.... in •ueseon:
AO
V
—�//6/✓J ❑ 'eat .. , .111 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 •, re is u • sure income,describe the use and portion
of the property utilized 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. Sign a of daimant '
'U(ti 1.(.„,,i65/_ 1.1
1 , y1S(number and street.city,state,and ZIP code) I /1[
��ycodw . 7co5 - OwPAsu11 P —I-n Y719
- fie U I ASSESSED.VALUE I. HOMESTEAD, -,NON-RESIDENTIAL -
• ASSESSOR USE ONLY I'TRUE TAX VALUE 1 AT 100%OF TTV .I -VALUE.. •.,1` - :'VALUE .-
Land not exceeding 1 (one)acre immediately (1) - .
surrounding residential improvements.
Other land I(2) .. _ .
Trial land(line 1 plus line 2) (3)
Dwelling (4) . -:. _\ .
Residential improvements or Annually
Assessed Mobile I Manufactured Home Garage (5) - - _ ' • - _ \ .
Other improvements (6) ' `•' - b
Total improvements(line 4 through line 6) (7)
Total value (line 3 plusline 7) (8) ;J
I hereby certify the above is true,correct,and Signature of Assessor
complete. Date signed(month,day,yr) I
Verifying action-Signature of Auditor „ \ r Date signed(month,day.year)
. . \O (b-' \ • \k__,J, K\ h (r) 4 A %
. - STANDARD DEDUCTION ALLOWANCE.• - _
a pay 20— 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011 - - -_ _:r
Lesser of 12
Homestead Valuation 44•000 for 2008 pay 2009 41,000 for 2011 pay 2012
or 43,000 for 2009 pay2010 40,000 $payable after 2012
Signature of Auditor
Date signed(month,day,year) -
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