Homestead_Robinson .CLAIM.FO.R HOMESTEAD PROPERTY'TAX --' ;_'YEAR
° n14 STANDARD/'SUPPLEMENTAL DEDUCTION FORM
\ 4�' State Form 5473(R18/1-20) HC10
�r; Prescribedby 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 und. IC•- 1137,___y
CERTIFICATION STATEMENT .r _�—
certify that I(we)occupied as my(our)principa
place of r= idence or am(are)buying the followin•t described real property under contract for which a,Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, (date ofsigE. Ie).3( /e2020
C Own. ❑ Am(are)buying under recorded contract.
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. '
0 Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified pe¢s r sfft(A�(kt.
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. GIBSONN COUNTY TOR
If buying on contract,Fee Simple owner's name '
Recorder's office where contract is recorded ' - Record number Page
PROPERTY D_ESCRIPTION
County. - Township Taking district(city,town,township) - f
•
Parcel number Legal desc' 'on ' Is the property in question:.
�(yeal property El 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.
:6 (a .---f - 6,Q - 3 -60O , 7 � 'of
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township' • Is-claimant vacating a homestead?
❑ Yes r No
igna re of claimant
I hereby certify the above statements are true,correct,and complete./ 0,42
Address of contact(num er and street,city,state,and ZIP code) d 1ess of vacated homestead, anyber and street,city,state,and Z/P code)
X 6i- 4,:�J. J 3 f. 126 • ' -,, (number 7'G S'
ASSESSOR USE ONLY - ASSESSED VALUE I HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately
surroundmg'residential improvements - (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4)
annually assessed mobile I
manufactured home: Garage - (5) •
Other improvements (6) •
'
Total improvements(line 4 through line 6) (7) ,
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature Of Auditor'o . 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 property or to a manufactured home that is not assessed as real property may
not exceed one-half(1/2)of the assessed value of the mobile home or manufactured home.
Signature of direr - - - Date signed(month,day,year)
c
DISTRIBUTION: Original-County Auditor,File-Stamped Copy-Taxpay .42
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