Homestead_Higgins (2) �. CLAIM FOR HOMESTEAD PROPERTY TAX
YEAR
/4- �\
Ii'r \ STANDARD / SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R19/1-23) HC10 a 3
•i• 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) 66SG,1:)/ 0....A W (k ZO\t(. certify that I(we)occupied as my(our)principal place of
residence or am(are)buyir the following describe re roperty under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date this application is signed, '7/25/oZ (date of signature).I(We):
[ n. ❑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.
County Township Taxing District(city,town,township)
G t\''. 4.On Io,n ow,ery .
Parcel Number Legal Description Is the protgrty in questio
alp-11-3I-300^o ot(. ?, -49 I QKal Property ❑Annualy 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.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township fir Is Claimant Vacating a Ho estead?
�-l .5
V� � v� L r� II, 0 Yes No
Si. ° ant
I hereby certify the above statements are true,correct,and complete.
Address of Contact(number and street,city,state,and ZIP code) - s of Vacated Homes �.n ber and street,city,state,and ZIP code)
ab h) 0.1 e; A • owe . • rN 4741,5
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement FILED
Other Land (2)
Total Land(line 1 plus line 2) (3)
Residential Improvements or Dwelling (4) JUL 2 5 2023 ,j47
Annually Assessed Mobile/
Manufactured Home Garage (5) Y22,`2f4C a 1/eb
Other Improvements (6) GIBSON COUNTY AUDITOR
Total Improvements(Line 4 through Line 6) (7)
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