Homestead_Wilson (14) r
: CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
v STANDARD I SUPPLEMENTAL DEDUCTION FORM
Slate Form 5479(RIB/1.20) HC90
Presenbed by the Department of Local Government Finance
INSTRUCTIONS See reverse ode for filing instructions
NOTE Telephone.Social Security,driver's hcense,stale identification and federal identification numbers are confidential under IC 6-1 1-12-37
-" 1 • "�` T ldCERTIFiCAT10N`.STATEyIENT" - °"
I(We) Chris Wilson&Jill Muensterman 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 6-Z y-Z"T'(date of signature). I(We):
® 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.
.
- _ -
Recorder's office wham contract is recorded - - - Record number Page
% - RO
•f
PPER✓iYQgE5CR ETI 10N�,� : ^�e�°c �. • ., . .y,;County W_ - Township Taxing distid(city,town,Township) -�o " ''
Gibson Ft. Branch Fort Branch
Parcel number Legal description - i
Is the property in question
26-18-13-402-000.282-026 ®Real Properly ❑Annually assessed mobile home(fC 6-1 1.7)
Bony portion of the resident al structure or the toed not exceeding one(II acre that immediately surrovrda that structure is used to preduco:enemo describe the use and portion
al the property all zed to produce Income
DOUGLAS ADD 1PTI2PT/3PT
,
a..•..-.- .,, - .o-$?.`o'_- „_.Z....tRROFERTY.OWNED^ELSEWHERE BBY44CLIAimANATi..,,...... .,.&"................•.:1.. ., Je r_"�..,......�,...w.i',
State.county,and Township Is claimant vacating a homestead?
Indiana,Gibson, Fort Branch —.is. A Yes T4 No
I hereby certify the above statements are true,correct,and complet-. i,
Address of contact(number and shoal,city,slate and ZIP coda) , . vacated homestead if any taumbor and stmt.ay,slate,and ZIP codal
400 N. Main St., Ft. Branch, IN 47648
iF r,-"""y raS SSO.13TOSNLP:' µ ' 1 IqA S BSteg,v L(UE�' CHONiESTt'AD A uE k"y11,76 �C 3IDENTIA
Land not exceeding one(1)acre Immediately ' ti surrounding residential Improvements (1) ....._____v A a i
Other land (2)
r--
Total land(floe 9 plus line 2) (3) 2420
Reuldentlal Improvements or Dwelling (4) v`
I �1,f'
annually assessed mobile I
manufactured home Garage (5)
Other Improvements (6)
Total Improvements(line 4 through line 6) (7)M"`_ ._ r M"rY - `pR
Total value (line 3 plus line 7) (g) 03SO1 GQU
I hereby certify the above Is true,correct, Signature of Assessor Date signed(month,day,yaw)
end complete.
Verifying action•Signature of Auditor
Data signed(month,day,yaw)
} R'" 'V p,. *': ..^*.x.x,rm+t vxa"s^'yr,w^a' _ 'w".•'T7i,':w.
a.._ .�. ti., ,Y,.:�,. .+"��q.,..,),.,.,,:-'.:�'_.f._.: ,..,STAND RDDEDUCTIO+�N"?ALLOY,VANCE� ^. w"r" ..".,»..r." 't" ,:"° r. -- `..
20 pay 20 Lesser of 60%of the assessed value of the homestead or S45,000.
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home S
that is not assessed as real property or to a manufactured home that is notassessed as real property may
not exceed one-half(1/2)of the assessed value of the mobile home or manufactured home.
S gn ure of Auditor ,
Date sign d(mon(,day,year)
DISTRIBUTION:Ongmat-County Auditor.File-Stamped Copy-Taxpay
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