Homestead_Lashbrook (2)1 NI
cct CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
efts
yy���yy,,' STANDARD/SUPPLEMENTAL DEDUCTION FORM
Smm Form 54T3(R1711-16) HCMO
Presorted or the Department or Local Gmarrint Fince
INSTRUCTIONS:See reverse side forging atstruG'ons
NOTE:Telephone,Social Seawix driver's'cense,data iiengicatm and federal Identficaffon mnoas are confidential under IC 6-1.1-12-37.
CERTIFICATION STATEMENT •
1 Mt) . U • I a • certify that l(we)occupied as my(our)pincipal
place of —..- •- or am(are)hying the layering described real properly under contract for vehidl a Homestead Property Tax Standard
,\t tRduction is hereby darned on the date this application is signed, (date of signature). I(We):
/(7-IC1bkir,_ ❑ 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 bust.
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
NseM
3otTh L�lvveo k .
Steel Seaver banter d Maaaats stasis fast Sid ages) kiva's&aa•I Itt rY iI Ors nntad danora ryave(am five�4ar. listingSttA
(A,tpiaSe atYlfapplom'a spa.dap ilia.a said semiynovaJ
s
It gulag o crust.Fee Skupan ants rams
RemLLls ogre where contract a ramdad Record ranter Peps
Carty ( k . _I •Ta*V rid(aY.tam arvuag)
e
PaorJ Lees desoiptco prcgely in gssmrc
Red rropaty ❑A.-nSy asaassed moat roe(IC 6-I.I-7)
Itany palm at The resgaud rare or the lard cmewee±rg one(I)acre svrn a oat lmmo:re um a used to produce goose,de tie me and par
ps ddm pro y aired b traduce Mom d \
It, - a- - lot -000 .2 3 - 02E .
Smm,Crary,and Township la claimant vacating a homestead?
0 Yes 0 No
I hereby certify the above statements are true,cored-and complete. S+�y!/////� `,d,C�J/
Address a cmtct(nuMva !died,day,tee,and ZIPole) yea m lll�.ad.I my ad sneer,city.xr.and VP:WO
_ - - :ASSESSOR USE ONLY - -,I :ASSESSEDVALUE,_._IL. HOMESTEAD VALUE_, b. NOU.RESIUENTIAL, (
Land not exceeding one(1)acre Immediately t'rR- > akP "t
surrounding resdentia hnpmvnnents (1) r to�._ S.&col ..? ,r
Other cod (2) �i+o ey 1u t:, j� IL
Total land(line 1 plus U.2) (3) J>,./j S
ResIdentIal improvements or Dwelling (4) rtcla. `..,tb e' i_..t:=
annually assessed mobile I mt� (� �, 1
manufactured home Garage (5) D`" zyV ��'l�� .4 .' '
Other improvements (6) . :.,:;,a\v�r„!-yt:;�.a�'�:,�
Total improvements(line 4 through line 6) f7) ... = - �(t/(
Total value (fine 3 pas line 7) (a) GIBSON COUNTY AUDITOR
I hereby certify the above is true,correct, 1ee crasser Data awed(on*sax read
and complete.
wsdybg adbn-Srpmere Saar Data signed(math day,year)
�'• '� -;- -. -. a „, "STANDARD DEDUCTIOtJ ALLO1NAIv'CE - �'
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000. •. } .-.
AbhwTstandug any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home 6
that is not assessed as real property orb a manufactured home that is not assessed as seal property may
not exceed one-half(1/2)of the assessed vase of or manufactured home.
/\r 5 ( M oar dor
12( day,
DISTRIBUTION:Odpaal-CoolyAudda,Pis3anped Copy-Tmmaya
Page 1 of 2