HomeMy WebLinkAboutHomestead_Middleton CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
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��r State Form 5473(R17/1-16) HOIO
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Security,driver's license,state identification and federal Identification numbers are confidential under IC 6-1.1-12-37.
1 CERTIFICATION STATEMENT
(We) 2en ►�e L ccL(2-40 r 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 on the date this application is signed, (date of signature). I(We):
19 r:/vm. ❑ 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.
Social Security number of claimant's spouse(last five digits) Driver's license/Identification/Other number of claimants spouse(fast five dgits) Issuing State
(Applicable only If applicant's spouse does not have a social security number.)
CONTRACT RECORDED
If buying on contract,Fee Simple owner's name
Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township Taxing d (city,town,township)
( bean v r khc /Th
_Parcel number Legal descripfion Is the^p�rop. n question:
I.1�'Reat property 0 Annually assessed mobile home(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is used to produce income,describe the use and portion
of the properly utilized to produce income.
8 uo - \ ._ 1,.o - O H OD L .0 g-- -bak .
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is cl�aim,�an cating a homestead?
fes ❑ No '
ure o d'm - (�
I hereby certify the above statements are true,correct,and complete. ' Siig natard }�`M�i`. j\ \---Or
Address of contact(numberand abcrk city,state,and Meade) I Address of/vacated homestead,if any(numbera street,cit,tc state,and ZIP-,•e)
'——I LA 1 i .• . . 411.1 ' LA -
ASSESSOR USE ONLY ASSESSED VALUE f HOMESTEAD VALUE NON-RESIDENTIALVALUE (fin- � A
Land not exceeding one(1)acreImmediately (1) s (1JO vV\ C'�—V�m/o`] '
surrounding residential improvements
Other land (2) .;.',
Total land(line 1 plus line 2) (3)
... .. .........— ....._,D
io .,,,,..,,,,, ,,._...,.. -,:ja-:,2,,, -,•:'::,::
Rest
Residential improvements or Dwelling (4)
annually assessed mobile!
manufactured home Garage (5) w
I.
Other improvements (6) JAN 17 2020
Total improvements(line 4 through line 6) (7)
Total value(line 3 pits line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor Date si '
. and complete. GIBSON COUNTY AUDITOR
Verifying action-Signature of Auditor Date signed(month,day,year) '.
STANDARD DEDUCTION ALLOWANCE
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000.
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 fo a mobile home $
that is not assessed as real prop or to a manufactured home that is not assessed as real property may
not exceed one-half(112)of the essed value of the mo Ile home ormanufactwed home.
Sign a f Auditor Date signed(month,day,year)
rl A.--1 -a-Oao
DISTRIBUTION:On Auditor,Fie-Stamped Copy- axpayer
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