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Homestead_Goedde (12) .,fir CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
4 '�- STANDARD/SUPPLEMENTAL DEDUCTION FORM
Sac Form S4T3(R17I 1-16) HCIO
Prescribed by me Depamsa d local Gorenmere Fate
e
NOINSTRUCTIONS:See reverse
Secsitebverrp7ense,Sor¢
NOTE Telephone,SONaI Security,driver's icense,state imlerm65raAfn and feterelT numbers are n5dettaJ wider IC 64.1-12-3
- I
I(We) I l JI 4m ,Ca,6-4-r3i.. A O eat d P certify that I(we)occupied as my(our)principal
place of residence or am( )buying the following described real property under contract for which a Homestead Property Tax 0 U 2018
Deduction is hereby claimed on the date this application is signed, (data of signature). I(We)
itt. ❑ Own. 0 Am(are)buying under recorded contract
❑ Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation- rr
�//fi�i'xI-•��
❑ Have a beneficial interest in the trust a the tight to ocamy the property under the terms of a qualified personal resideno i5t
❑ Alm(are)the shareholder, partner, or member of the entity that owns the property. GIBBON COL NTY AUDITOR
Na�me a claimant(legal roma) T
cul"
I r a as ScOae((.—as elt
/ a(ed��Sow�
Reorders office Where cataract is bred R.mrd reenter Page
Canty T°amsh'Pn ' �� " Truig&arid( lain faurNP)
GIe vphdi5� ahnsan Twits Ate
Pam nsvmaer tape dea�iptam Is are in question
Real gamely ❑.4evm!y maned mote,lee(IC 6-1.1-0
II any per on a the 25pa0a tmmae aen lad relessnlc an(1)acre that nune&ately eunaaos eat stmm.a is used to proatee florae deacte to me and porecn
a de Frvpay taleed to Pv&m mart
24. -/9.32- yco— oo2 . 92,5- D(2 '
_ PROPERTY OWNED ELSEtYHERE BY CLAIMANT. -. r
Sze.Cana.and_y TO*nYtlp , / Is claimant vacating a homestead?
N Gibs oY), 0/Critm 5anJ ❑ Yes ❑ No
.ssaedtlamss 4/ /
I hereby rutty the above statements are true,COfled,and complete. ��JJ I,
d ramtaa(number aa soa2 crty, aid ZIP coat) Aml&ana+alatl lmanest:etl.a ,!lk..wsaer./m.rsa and Zamarle)
696 1O25 iloocifizt IN 4763' {
ASSESSOR 115E ONLY _ ) ASSESSED VALUE- ',.I. HOLlESTEAD VALUE i �' .NON-RE IINTIAL DE _
surroundt ing esdntiiralle(nl)prwemmmmnb_: CO --s ; - s.
xl ;
Total land(lire 1 plus line 2) (3)
7.1
Residential bnprovemerts or Dwelling (4) ;s _ 3 --
nmualy assessed mobile/ t!Ffal -.et -.t-:.,t .j mandachi red home Garage (5) _:.?A.s_—,..�.- i. ... >:_
Other Improvements (6) ._fV:.._t -1 ^%_
Total improvements(lime 4 through line 6) (7)
Total value (line 3 phs lane 7) (8)
I hereby certify the above is true,correct, S rtAtaes.a Ore sired(t:slk dolt year)
and complete.
Venire eaten-Signature orAudio Data steed(month day.year)
.e . . - f'STANDARDDEDUCTIONALLOWANCE; - _ -- .
20 (R pay 20 Lesser of 60%of the assessed vdue of the homestead cc$45,000.
Not serstandlng any other provision,the sum of the deductions provided In IC 6-1.1-12 to a mobile home $ •
that is not assessed as real property orb a manufactured home Mans not assessed as teal property may
not exceed one-hat(12)rettthh`ee assessed value d the mobile home or manufactured home.
siTabn d��S.J(YI.C'Y/V Data dgrea maze.2_0 rem
06LRQtUfION: Audhr.Fe.- dCccy-T er
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