Homestead_Malone (2) Ci.iN1.:;1:14,-,
� CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
a, STANDARDISUPPLEMENTALDEDUCTIONFORM r'')r}/ State Form 5473(R18/1-20) HCIO c: -
J 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) z-a4har,A d Mari a 1 _Al a(O✓I a 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, 9/ 8/a a (date of signature). I(We):
1110.4:frvn. ❑ 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
If buying on contract.Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township Taxing district(City town.township)
C 003on \ c•.vc+Pr or
Parcel number Legal description o i Is the propertyin question:
-26-/off-o(o_a 0 3 &W. /?' -00143 1 h Real property ❑ Annually assessed minippm c 1.Z�1 2
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- ie used lrtic T
of the property utilized to produce income. ,
-i • -.. -117.
GIBSON COUNTY AU:'ITOR
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County.and Township Is claimant vacating a homestead?
❑ Yes
Signs a of claimant .-
I hereby certify the above statements are true,correct,and complete. lJ yi ,
Address of contact(number and street.city state.and ZIP code) Address of vacated homestead if any(number and street.city state.and ZIP code)
,10 AL a-'r. Ln pf,ci,ce an 1 L1767
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
•
Land not exceeding one(1)acre Immediately fit) -
surrounding residential improvements _
Other land (2) _- —^ -yr>Favzi��.ers•a.a
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4)
annually assessed mobile/
manufactured home Garage (5) ... ,
,t
Other improvements (6) t' `•WF.ti
Total Improvements(line 4 through line 6) (7)
Total value (line 3 plcm line 7) (8)
Signature of Assessor Date signed(month,day.year)
I hereby certify the above Is true,correct,
and complete.
Verifying action-Signature of Auditor Dale 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! r lv r� Date signed(month,day.year)
/fy I -/,IAv/I // O/. .'
DISTRIBUTION: Original-County Auditor.File-Stamped Copy-Taxpayer
Page 1 of 2