Homestead_Farney . CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
aliSa STANDARD/SUPPLEMENTAL DEDUCTION FORM
i Stale Form 5473(R16/1.20) HC10 2022
1 Pmscnbed 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) Brandon& Lexus Farney certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real property ul�e con act for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, (O/'t�(p I --2.- (date of signature). I(We):
I ( Own. 0 Am(are)buying under recorded contract.((((
0 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 personal residence trust.
0 Am(are)the shareholder,partner,or member of the entity that owns the property.
If buying on contract,Fee Simple owners name
Recorder's o1M1ce wM1ers contract is recorded
- --- - T Record number Page
•
PROPERTY DESCRIPTION —
Courtly Township Taxing district(ply,town,township)
Gibson Union Union
Parch number Legal dasulplbn -- - �»111e Pmpelty In question- N 1'v 4 2022
26 18-08 300-002.457-025 SW SE&SE SW 8-3-10 10.608 AC. m Real p1openy' O A maa assessed moose home(IC f 1.1-7)
If any porpon of the ed to income
or the land not exceeding one(1)awe that immediately surrounds that cln,clura ro used to Produce Income,describe by
use and portico
of the property utilized to produce into ne
GIBSOIN COUNTY AUDITOR
ir
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State.Courtly.end Township Is claimant vacating a homestead?
0 Yes ® No
$tone re or day r. .
I hereby certify the above statements are true,correct,and complete. _Q_ _
Address of contact(number end street.city state,and ZIP cods) Address of vacated homestead.it any(number end st city,state,and ZIP code)
1208 E 650 S,Ft.Branch,IN 47648
ASSESSOR USE ONLY ASSESSED VAt llI HOMESTEAD VALUE • NON-RESIDENTIAL
VALUE.
Land not exceeding one(1)acre Immediately (1)
surrounding residential Improvements _ t —
Other land (2) I
Total land(line 1 plus line 2) (3) - — .
__-_ _ - _
Residential Improvements or Dwelling (4)
annually assessed mobile/ '----------— —
manufactured horn. Garage (5)
Other Improvements (6)
Total Improvements(lane 4 through line 6) (7) _.. _
Total value (line 3 plus line 7) --- (6)
Signature of Assessor Dale signed(month.day,year)
thereby certify the above Is true,correct,
and complete.
VarYyetp action-Signature of Aaelor Date coned(rnonth day.ye
STANDARD DEDUCTION ALLOWANCE
20 pay 20 Lesser of 60%of the assessed value of the homestead or S45.000.
' Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home S
q 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 valet the mobile home or manufactured home. A 1
I /�Qs /((((( Dale signed(7t/r.day.year) \1/
Signelura of Audi + • 11/ I1 \
IDISTRIBUTION:Original-County Auditor.FlleSiemped Copy-Taxpayer
I•r,/!!% a/ /J \
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