Homestead_Potts /•f�� ,, CLAIM FOR HOMESTEAD PROPERTY TAX --� r YEAR )
1$ STANDARD/SUPPLEMENTAL DEDUCTION FORM
2
\ �/t State Form 5473(Rt9/1-23) HC 10 73 ,
�.r Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions `I �/-�}
NOTE Telephone,Social Secunly,driver's license.state identification and federal identification numbers are confidential under IC 6-1 1-12-37. 1 40 1 S3I-% In le.t+.
CERTIFICATION STATEMENT ^ n
I(We) M. , •1 14e1Nite • S certify that I(we)occupied as my(our)principal place of 22 f I
residence or am(are)buying the following escribed real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the 1
date thi application is signed. ,'I �s (date of signature) I(Wel
n ❑Am(are'buying under recorded contract
❑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
❑Mr(are)the shareholder,partner,or member of the entity that owns the property
1 Recorder's Office Where Contract is Recorded 7 Reco-o'umber 7 Page
PROPERTY DESCRIPTION
County Township ` Taxing District(city town.township)
i &I.bsoA O2 \ .
M°��°� `Cr`,
!Parcel Number M ��Le[ Cgal Desc�npQhonn Is the property in question
ab-1\-1 \-300—/ ga— /v• oat ❑Real Property 0 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 immed.ately surrounds that structure is used to produce income describe the use and portion
of the property utilized to produce income 1 ///(
(
G�
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State.County,and Township Is Claimant Vacating a Homestead')
❑ es L?No
a _ ��, vi\
I hereby certify the above statements are true.correct.and complete
Address of Contact number and street.city state and ZIP code) Address of/acated Homestead.if any(number and street city.state and ZIP cod-;
ain§aviewv'swig"7;,-,10.4e r-isr.mn. aria-.Irmo..lim wiMirm v-Z77-
re if, III
ASSESSOR USE ONLY I ASSESSED VALUE HOMESTEAD VALUE I NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1) ,)( �
Surrounding Residential Improvement
Other Land 121 b(\
v
i Total Land(line 1 plus line 2) (3) t(T ,tomAnnually A Imssed Mobil or Dwelling (4) FitED \\_(v�JAnnually Assessed Mobile I `j'
I Manufactured Home i Garage i(5) I
Other Improvements I(6)
DEC L 2023 o
Total Improvements(Line 4 through Line 6) (7) I)
1 Total Value(Line 3 plus Line 7) 1(81 i
( 0'Signatu-e of assessor rs (d/ month.yearl
a k
I hereby certify the above is true,correct,and complete. ! GIBSON COUNTY AUDITOR.
I Verifying Action-Signature of Auditor Date Signed I a month,year)
•
STANDARD DEDUCTION ALLOWANCE
20 Pay 20 Lesser of 60%of the assessed value of the homestead or$46 000
NOty ithstanding any other provision.the sum of the deductions provided in IC 6-1 1-12 to a mobile home that S
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 value of the mobile home or manufactured home
Signature of Auditor Date Signed(month day year)
DISTRIBUTION: Original-County Auditor File-Stamped Copy-Taxpayer
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