Homestead_Pinkston e'"�"�'�°� CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
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I\ STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R19/1-23) HC10 24:,2a
Prescribed by the Department of Lcca:3evernmert 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) • l ,1 t) _ certify that I(we)occupied as my(our)principal place of
residence or am(are)buying th- ollowing described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date . application is signed, (date of signature) I(We)
Own ❑Am(are)buying under recorded contract
(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
❑Am(are)the shareholder,partner.or member of the entity that owns the property
If Buying on Contract.Fee Simple Owners Name
Recorder's Office Where Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
County , Township C ^ . mg District(city town.township)
GParcel Number Legal Description Is the pr perty in question
eal Property ❑Annually Assessed Mobie Home(IC 6-1 1-7)
If any portion of sidential structure or the land not exceeding one(1)acre that immediately surrou hat structure is used to produce income.describe the use and portion
of the property utilized to produce income
-2_ 6-12._oz - 14 0 00 LI . s--1_ oaf .
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State.County,and Township Is Irnt Vacating a Homestead/
1- I Yes ❑No
I hereby certify the above statements are true,correct,and complete l ���4,' =1.it
Address of Contact(number and street,city stale and ZIP code) ess of Va ated Honest•..,it any'number and street.cam.st. - -nd ZIP c••el
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE :JON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement _
Other Land (2) IEDTotal Land(line 1 plus line 2) (3) FResidential Improvements or Dwelling (4)
Annually Assessed Mobile/
Manufactured Home Garage (5) NOV 1 7 2023
Other Improvements (6)
Total Improvements(Line 4 through Line 6) (7) '[4ll . 1414`,i
Total Value(Line 3plus Line 7) (8) GIBSON COUNTY AUDITOR
Signature of Assessor Date Signed(date.month.year)
I hereby certify the above is true,correct,and complete.
Verifying Action-Signature of Auditor I Date Signed(date month.year)
STANDARD DEDUCTION ALLOWANCE
20 Pay 20 Lesser of 60%of the assessed value of the homestead or 548.000
Notwithstanding any other provision,the sum of the deductions provided in 6-1 1-1 to- obile home that $
is not assessed as real property or to a manufactured home that is not as--SS-• -,rea pro.-ny may not
exceed one-half(1/2)///off the asses value of the mobile home or mans=ctu-d home
��`
Signature of Auditor y `n ��l�� Date Sigjed month \ ar );:-.32)
DISTRIBUTION: Onginal-County Auditor File-Stamped Copy-Taxpayer
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