Homestead_Henico ,tea• CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
s,: ;^e STANDARD!SUPPLEMENTAL DEDUCTION wI
‘itarif—.. Sera Pam 54730117/1-16) 14C10 �y��
a
PneaatLe0 byy fie Depen ea al Oojvn,e 1Fi I I
INSTRUCTIONS:See reverse side loafing austJum'ons. ' ;,,
NOTE Telephone,Social Seardy, lane,driver's slate itn0's m caf and federalideaID3catim numbers are nvfideldial under IC 6-1.1-1 - .
CERTIFICATION STATEMENT . - - A. - - -- ,
1(We) 4_ -% _- .a. • Ali. 7 certify that I(we)ocarpied as A4M)Ohsil I a
place of residence a It(are)buying the following described real property under contract for which a Homestead Property Tax Stand '
^DDedu``ction is hereby claimed on the date this appl cetion is signed, (date of sgnah/, . I(We):
,aeve . 0 Am(are)buying under recorded contract. ,. • jT1►Ii
❑ Am(are)entitled to occupy as a tenant-smtldwlder of a cooperative housing corporation. GIBSON COUNTv
❑ Have a betters-IA interest in the trust a the right to omgry the property under the terms of a qualified personal residence Miami/II ITOR
0 Am(are)the shareholder, partner,or member of the entity that owns the property.
CLAIMANTS INFORMATION - - - -
Nasdeanea(fgdram)
_
somtStony cumber at stemmata spouse(lest five ages) Drivers lime /Ideit5 tear!Other roots of dainwte spouse past 6w d9) (sating State
(Amilhable oiryaapplvras spans ems me law a soder s ty exeter)
C Metro on mead,Fee Some cats ram
RemNe's slim Wise arced is recorded Read natte Page
-PROPERTY DESCRIPTION' '- - - --. .-
County
Taxing dsu(ay Men,ptwsNp)
l/•t' - Ce raj_joacics
Pod combo La�ldacpeen l Is the reoDcty in weseas
Pled 1 Varty ❑A.-mmty®erred mobile Joe(PC 6-1.1-7)
II try prom d the resperma aurae mite Ian not exreedrg fie(1)me tot immediately wands tat smxura is used to prolate scare,desabe the use and Perko
al the properly tulbed to pore lemur.
&o -\9 -• 3•1 - 30� - Oo0 . 3ls �COGI - .
. PROPERTY OV- EDELSESVHERE BYCLAlMANT '(J•_.,_./..^
Srae,Cady.aid To'evhp Is clamant racoon a homestead?
❑ Yes ❑ No
I hereby Certify the above statements am true,Carta,and COmplele- t/ e, to/ L.
Address d contact(tvxteea steel city,stab.ad 2IPcaft) Ir
...__d -- _.._.. ran(in teratspea,rar.s3-e,and ZIPcode)
ICS& u>•C'�bsonS -. Paal2r . - fz) a csr
ASSESSOR USE ONLY - ; 'ASSESSED VALUE -I HOMESTEAD VALUE ' I _1��!"R pLIUENTIAL `.
Land not exceeding one(1)acre immediately. . 11) s g' --f2i . ,v '2,,LG
m suruodm residential improvements
Other land (2) • 0r",{:4'+.'Ys=.` .s..'::
Total land(lire I plus Ere 2) (3)
Resident improvements or Dwelling (4) "x-
annually assessed mobile I - s V�
manufactured home Garage (5) a } 4 ,,,
Other improvements CO xd 5:k 1.K r-s t T
}}l� �%
TOW Improvements oneamrwgh line 6) m YY" O� /
Toad value pare 3 pas One n (a) '�p%
herebyI the above is true,conect, slv+sD+e of Assessor Doe staled(mat lea) -vev, . SO\-(OEy
a
plete.
Verifying rum-SCnaeve OAedmr Cote Speed(moats •JtN'�-r
20_pay 20 Lesser of 60%of the assessed value of the homestead or$45,000. G • .
AbMBhstanong any other provision,the sum of the deductions provided hi IC 6-1.1-12 to a mobile home $
that is not esmssed as teal properly or to a manufactured home dons not assessed as real property may
rot exceed one-hall(V of the assess of the mobiie lone or mamAacaacd hone.
SJrt a rAudta Date tlptad(and%day,tear)
DtSTRIBl1TION:Onrpel-CoutyAct.Ji-Sanped Copy-Tasprfa
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