Homestead_Byrns (9) e/ 3'\ CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
} � STANDARD/SUPPLEMENTAL DEDUCTION HC10 ,�
• State Form 5473(RIB/1-20)
` Prescribed by the Department of Local Govemment Finance /�
INSTRUCTIONS:See reverse side for filing instructions.
CERTIFICATION STATEMENT
•
I(We) 3p6 ro" Thone-reAS Byeni 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, - (date of signature). I(We):
LTUwn. ❑ 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. a
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
(ppli one yi I a ppiican spouse
d
CONTRACT RECORDED
If buying on contract.Fee Simple owners name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township Taxing district(city to n.township)
G r bS �^/�/O/! awrPi _
Parcel number Legal description i Is the prop in question.
-/O j",300 000_ aaa_c i I I 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
PROPERTY OWNED ELSEWHERE=Y CLAIMANT
State,County.and Township Is claimant vacatin a homestead?
Ts'/ G t` . A.CrY�, ❑ Yes o
10• N. Sign cur of claimant
I hereby certify the above statements are true,correct,and complete. ( A O{ 3c 0IA7 Vvta3 _(AILS
Addr ss of contact(number and street,city,state.and ZIP cadet Addre ted h meste d.if ny(num creed street,city.state.and ZIP code)
Ai 4 w 0 Q ,11-e- J 41 b.
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately (1) r -
surroundingresidentialimprovements - -- -- - - ---%-
Other land (2) _ -Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4) ..
annually assessed mobile/ _
manufactured home Garage (5)
Other Improvements (6) rid,:.',-;...- .'V x'i.'•
'""--t ,e. 4: AU6 2 3 2022
Total Improvements(line 4 through line 6) (7)
Total value (line 3 pEw line 7) (6) _ d� '�
Signature of Assessor
Ind ocertifythe above Is true,correct, GIBSON COUNTY All
and complete. __ _ AUDITOR
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 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-hall(1/2)of the assessed value of the mobile home or manufactured home.
Sign ditor �% Ill/— Date signed(month.day.year)
DISTRIBUTION: Original-County Auditor.File-Stamped Copy-Taxpayer
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