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Homestead_Bishop (3) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR FORM STANDARD/SUPPLEMENTAL DEDUCTION 2020 a( ll State Form 5473(R18/1-20) HC1O ° 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. CERTIFICATION STATEMENT i l- I(We) '(ynno, LS i 1 op certify that I(we)occupied as my(our)principal place of residence or am(are)buying the Ilawing 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): Own. ❑ Am(are)buying under recorded contract. '❑ m(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. ❑ PROPERTY DESCRIPTION County f Township Taxing district(city,town,township) 020 G\1p ov / 1O Parcel number Legal description Is property in question: Real property ❑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 property utilized to produce income. off ()- ° 3u - 000 eLtg- d2a PROPERTY OWNED ELSEWHERE BY CLAIMANT State,county,and Township Is claim nt vacating a homestead? Yes ❑ No ASi nature of claimant I hereby certify the above statements are true,correct,and complete. O"74"l.( 3i / Address of contact(number and street city,state,and ZIP code) Address of vacated homestead,it any(number and street,city,st ,and ZIP code) • ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE I NON- ESIDENTIAL VALU Land not exceeding one(1)acre immediately (1) surrounding residential improvements Other land (2) Total land(line 1 plus line 2) (3) t' Residential improvements or Dwelling (4) F op annually assessed mobile/ • manufactured home Garage (5) Other improvements (6) Nov 5 2020 Total improvements(line 4 through line 6) (7) IV Total value (line 3 plus line 7) (8) I hereby certify the above is true,correct, Signature of Assessor -I IQ nn,r att Date signed(month,day,year) and complete. �Jn,TY AUDITOR Verifying action-Signature of Auditor GIBSON CO 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 to a mobile home $ that is not assessed as real•••-' or to a manufactured t is not assessed as real property may not exceed one-half(1r2)o sessed value of the ile home manufactured home. Signature of Auditor 1 ` "' Date signecTonth,,year) DISTRIBUTION: Original-County Auditor,File-Stamped Copy-Taxpayer Page 1 of 2