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Homestead_Hunt CLAIM FOR HOMESTEAD PROPERTY TAX C. 00FORM STANDARD/SUPPLEMENTAL DEDUCTION HC1D �`r State Form 5473(R18/1-20) 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(We) Janet Hunt 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, 03/16/2022 (date of signature). I(We): iZI Own. ❑ 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. CLAIMANT'S INFORMATION Name of claimant's spouse(legal name) Social Security number of claimant's spouse(last five digits) Driver's license/Identification/Other number of claimant's spouse de di or IssuinII(Applicable only if applicant's spouse does not have a social security number) ����,� CONTRACT RECORDED If buying on contract,Fee Simple owner's name 2022 Recorders office where contract is recorded -- •rd number Page PROPERTY DESCRIPTION G'B,Oxc J - �\ County Township Taxing district(cay,jown,township) OR O) Gibson Center �/V[�A0 Li Parcel number Legal description Is the property in question: 26-13-33-300-001 m Real property ❑ Annually assessed mobile home(/C 6-1.1-7) .st u 7-004 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. • PROPERTY OWNED ELSEWHERE BY CLAIMANT O Is claimant vacating a homestead? t. State,County,and Township Yes ❑ Na CD Indiana,Gibson, Union signalvreofclaims t 0 rl/-� - I hereby certify the above statements are true,correct,and complete. d), Address of contact(number and street,city,state,and ZIP code) Addresi of vacated homestead,if any(number and street,city,state,and ZIP code) ` �^ 4386 S 750 E Francisco, IN 47649 7019 S 300 E Fort Branch, IN 47648 sold 11/20 �_� ; ..._.-..._.._ _ ASSC:f:.C©-VpcL4fE- •,--I•T-- #19MESTEAU VA6{�E--_� .--_.. NONftaENT1Al. _ 1 ---. ASSESSOR USE ONLY '-- V surrounding resideLand not ntial improvementsone(1)acre diately (1) Other land (2) Total land(line 1 plus line 2) (3) -- Residential improvements or 1 Dwelling (4) annually assessed mobile I Garage (5) manufactured home Other Improvements (6) Total improvements(line 4 through line 6) (7) Total value (line 3 plus line 7) (8) Date signed(mourn,day,year) I hereby certify the above is true,correct, Signature of Assessor and complete. Date signed(month,day,year)Verifying action-Signature of Auditor 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 lC 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 Auditor Date signed(month,day,year) "1 ' � a.s�- Q c_ `� � `t- „ ,,,�) 'r'i -�. .>-Z� dOa DISTRIBUTION: Original-County Auditor,File-Stamped Copy-Taxpayer Page 1 of 2