Homestead_Seale CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
t'•-c` STANDARD/SUPPLEMENTAL DEDUCTION FORM -i�„E Sale Form 5473gt17/1-16) H 'C10 20 I •
�Fa3� Predated by Me DeperersintRta19Goverment-- -_
INSTRUC17ONS:See teversa side for Erug frabucUoi
NOTE:Tekpaone,Sodal Saturn's(otter's amuse,state iier55mbr and federal IdertgcaWn roasters are confda&af under IC 61.1-12-37.
I Mk) I1 ' • certify that I(we)occupied as my(our)principal
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 m the date this application is signed, (date of signature). I(We):
pQ Ovm. ❑ Am(are)buying under recorded contract
-/il'y"�A`_a(are) entitled to ocapy as a tenant-stockholder of a cooperati.e housing corporation.
❑ Nave a beneficial interest in the trust or the right to oc ipy the property under the terms of a qualified personal residence trust
❑ Am(are)the shareholder, partner,or member of(the
�entity that owns the property. �
Some smog(what'ardmaaKo spouse(lag Eve Gals) Daeas item.I tcSL a t spore gag be cagey Taxing Sae
VICPrade slylap:da i s spasm Gass not hose a=dal scatty name)
• :Turn
- 'CONTRACT PEZOP9E'J
•
II Rrpg an mtracl Fee Sample comers name
Remakes Kaa where contract is recorded Read nuntrr Page
GIBSON COUNTY AUDITOR
. PROPERTY OESCRIPTON' - - -.
Toasis Tait deem(day,town beneath
,bstA . 1-\--1 4 .
lepmao
Red poppy ❑Annually sneered mote.lea(IC 6-1.1-7)
taro Porten d the residential smmre ode bps not
ere mat ds mhg one ace imnesN m is used b Meanaal
d ru mo e,describe the use ad porte pwa+y cared produce odce irm.a
a(., III_ CA- . 01- 001 31-t18 -026 .
_PROPERTY OWNED.ELSEWHERE BY CLAIMANT .-,-
State,Couay,and Township
car •
/El : • .
I hereby certify the above statements are true,correctand complete.Address d min(maths-a str d eet city stare,ad ZIPmde)
X _ d ^--• sap pammaetl stied,dy,s3b,wdi3PcaY)
MS—CI S• vS ,_ AA
ASSESSOR USE ONLY' ._ 1 ASSESSED VALUE 11 -. HOMESTEAD VALUE,-........K.,:? N9r. RE�SIUENTIAL-55
Land not exceeding one(1)acre Manta:n*1y x.<< _
surrounding residential Improvements (1) t Av' ' _'i 4 .%
Other land (2) �P _`fir ryl;.�=<4
Total land grne 1 plus One 2) (3)
Residential improvements or Dwelling (4) -.v}ia s
annually assessed mobile l ,r s *_- i _
manufactured home Omega (5)Other improvements (6) *'"-s. A:M t,__a_, g0
Total Improvements(line 4 though One a) CO
Total value tune 3 phi One 7) tie)
I hereby certify the above is true,correct, Sine oA«w Dab sited(nvsq say rein
and complete.
Voting action-Sipmire of Audi"( Ore biped(meraA da):)'an
20 pay 20 Lesser of 60%of the assessed voue of the homestead or$45,000.
Notwithstanang any other provision,the sum of the deductions provi4W in IC 6-1.1-12 to a motile home $
that is not assessed as real property or to a manufacbrred horn that is not a>.- as realpopedy may
not exceed oflhe assessed robe
mobile home or
lpi 5tsredAudW �
` M 5 n �Month IS .
WSiitl01RiON:aquvl-Catty Ass,Fle-&anted Copy•Ta'ysyer
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