Homestead_Michel (14) f CLAIM FOR HOMESTEAD PROPERTYTAX YEAR
rs 1. STANDARD!SUPPLEMENTAL DEDUCTION FORM
ir ai Slate Rem S473(RIF/t-16) HC10
Prescribed by the Derma of tool Geremmv Finance
INSTRUCTIONS:See reverse side forting Nsbvcfons.
NOTE Telephone,Social Seaodx&Wets license,state 6fenSSU5on and federal Identification ntanbera are ca tdeNrsl under IC 6-1.1-12-37.
I(We) all eAP . `G P certify that I(lyre)occupied as my(our)papal
place of residence or am(are)buying the following described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed an the date this application is signed, (date of signature). I(We):
yJL Own. 0 Am(are)buying Under recorded contract
❑ (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the trust a the light to ocaupy the property under the terms of a qualified personal residence that.
❑ Am(are)the shareholder, partner, or member of the entity that owns the property.
-
. - • - ,
Castyw\I o / ToenhiP �� Tmig dabid(may,town,hawse)
NA
qaa raaaber 1021, � D'^1 /s pmpary in R
Real pages& ❑Aavely assessed=bee tin(/C 6-I.1-I)
earn portion a the residential seuCue or es laid not mescal;one(1)ace that earevaaey seumre is used in produce interne,Oman:.to use and pernan
a to properly trifled In prcd=vxvm.
2 -19 - \i - 400 —Q060_Z /- 023-
-tki: _,- --t,fix= a tr3 sr — ah
Sete,Cant',aid Teens?* Is daimait vacating a homestead?
❑ Yes ❑ No
I hereby certify tie above statements are true,correct,and ODmpl \� •
Address of (numbs ad sheet.M Y.state ad ZIP at vacated hxhesbv,Wan 4mrcer ad icey state end A/ \��) .
SZ�1 -13-os i' �` •
'ASSESSOR USE ONLY 5 �jr) AS_SESSED VALUE{`mot ' "`HOMES•TEAD VALUE_I ttO�#ESIDENTIAL J
,Land not exceedingrest Immediately (1) � i # $ xL p zh
Land nid-mg residential Yv1)WnnemBrlb w , Y'
Other land -
(2) Y ....
Total land(line 1 plus line 2) (3) OCT1
Residential improvements or Dwelling (4) C fl?U 1 -.'.l' 3rr
annually assessed mobile _ ,. ,e. s::°.-'is:r:
-csr
manctartured home Garage (5) `2;.S 4 re y" "
Other Improvements (6) x - 3... ., _/
Total improvements(Ibe/through line 6) (7) GIBSON COUFJTY AUDITOR
Total value (line 3 plus linen (6)
SagsaI hereby certify the above is true,correct,
aA<.a.a pate sited(rnoreh,oby,yea)
and complete.
Verifying anion-Sig atae of Matt Data signed(nMh,day,year)
.'F.ie; 7`G:.-T :4111166,1s4r a•�sr.STANDARD DEDUCTION ALLOWANCE -v.- '-t
20 pay 20 Lesser of 6096 of the assessed value of the homestead or S45,000.
Notw7hstaMvg any other provision,the son of the deductions provided in IC 6-1.1-12 b a meet.harm S
Matls not assessed es real property orb a manufadwud home that is s«<sed as nut property may
not exceed one-hat(I/7)afte assessed value of the nffile or home.
wean
te
a h slylcmin cesf3 1*Nee tante my,Veen
0 I 1 g.
DISTRIBUTION:Original-Casty Ar era-.File-Stamped Cagy-Tagaya
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