Homestead_Bradshaw CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
i• , STANDARD I SUPPLEMENTAL DEDUCTION FORM
Sate Form 5473(R1711-16) HC10 2019
nresenbed by me Department or Local Government Finance
INSTRUCTIONS.See reverse sde for filing instructions
NOTE:ie,tephone.Social Sevents other's license,stare identification and federal idenfihcation numbers are confidential under IC 6-1.1-12-37.
I(we) Eric a lenneer Bradshaw certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following desaibea real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, eglla (date of signature). I One):
Own. 0 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 trust.
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
:
''•ken t,.. >.'. Tri
If boring an contract.Fee Simple a.aners Harz
Recoroers office unere coned is recordec Record number Page
I +la--",, n:. y a j%if`"-- etw 7. :EcicUrae. '.' c L Tdvi;ni ^I':W4t.,,,, ',-:Y i "S ' ars. %v_
county Township Taavg dsv,cf(my.Iowa tease*,
Gibson Montgomery
Parcel number Legal cesec:o n Its Me proper:inauest.cn:
Kt Real progeny 0 Annually assessedose home(IC Uf.1-71
if any portion of the residetbal s^_'dure aid vie and not exceeding One(1)acre that lnvrraately surrounds Mal structure is urea to Produce income.describe the use and cocoon
of tee property utezed to produce income
26-11-31-400-004.824-021
_-,;:ai . 7-e i: T`t n-
uti;..
Slate..Catunru,and Tomsvo Is claimant vacating a homestead?
n Yes 0 No
Signature or claimant
I hereby certify the above statements are true,correct,ano complete. 9-4
1,,.I. ^{ti/7?•--
Peeress of contact(number and street.rev sate.ara?lncodet Address of vacated homestead,if any(number and street,rig Yam.ano ZtProde)
5730 W Old Princeton Rd, Owensville, IN 47665 605 S Center St., Ft. Branch, IN 47648
�F ram'= --r SS ASSEOR USE'ONLY.r T d r .k,ASSESSED VALUE'7 7 I...:HOMTEAD VALUE.:
ESE ;Y �4'�nx3 NON-RESIDENitAL�fX:1
Land not exceeding one(1)acre immediately (1) I 1
surrounding residential improvements
Other land (2)
Total land(line 1 plus line 2) I(3)
Residential improvements or I Dwelling (4) -
six
nu llctyt assesseduredstl home
mobild!mI FILE
an `
manufactured Garage (5't
Other improvements I(6)
Total improvements(line 4 through line 6) I(7) I
Total value (line 3 plus line 7) (6) I —AUG 0 9 Z019
I hereby certify the above is true,correct, I Svpnawer of Assessor Dab signed(snoods day seen I
and complete. I ty ����
✓ ing action.Signature of Audnac Date Sig d _
GIBSON COUNTY AUDITOR
pi —..,a±fir. E'.2,+•;;.: i.: i"_tif;!afiy,G :ea- rT;?tM'1.•iartfx`}..u`:: ,a.x^.OM.sn-nl
20 pay 20 Lesser of 60%of the assessed vane of the homestead or 545,000.
Notnitnstandrng any other provision.the sum o'the deoucbhns provided in IC 6-l.I-I2 to a motile come $
oat is no:assessed as real property or to a manufactured home that is not assessed as real properly may
not emceed one-hall(ell)d the assessed value of the mobile home or manufactured borne.
Sion:are of Auditor Date signed(nwe&day lean
a.:,,_.9,,..f_l r:*' 8/09/19
DISTRIBUTION: Orgtal-Stowe)Auatior.File-Stamped Coo,-;soarer
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