Homestead_Wilson (4) �fi RAC
� ,: a CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
" . STANDARD/SUPPLEMENTAL DEDUCTION
2023
° �y�' State Form 5473(R18/1-20) HC10
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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) Robert Wilson 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, 4/5/2023 • (date of signature). I(We):
® Own. ❑ Am (are) buying under recorded contract.
❑ Am (are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
El Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust.
El Am (are) the shareholder, partner, or member of the entity that owns the property.
(Applicable only if applicant's spouse does not have a social security number.)
CONTRACT RECORDED
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)
Gibson Oakland City Gibson, Oakland City
Parcel number Legal description Is the property in question:
26-14-18-302-000.355-007 WEST ENLG 3 PT/4 PT BLK 7 Real 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 inco , sat e s and portion
of the property utilized to produce income.
/A
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
Signature of clad/
I hereby certify the above statements are true, correct, and complete.
Address of contact(number and street,city,state,and ZIP code) Addr ss of vacated homestead,i any(number and street,city,state,and ZIP code)
219 N Mulberry, Oakland City, IN 47660 51 W Washington, Oakland City, IN 47660
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately (1)
surrounding residential improvements
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4) t./!„
annually assessed mobile I APR
manufactured home Garage (5) V 5
�'3
Other improvements (6)
• �; �
Total improvements(line 4 through line 6) (7) vest, Cco
O N Z 1reief•
TY,rtUUITQ�
Total value (line 3 plus line 7) (8)
Ihereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
STANDARD DEDUCTION ALLOWANCE