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Homestead_Kuhlenschmidt .� CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR l fix ' 2;q\ STANDARD/SUPPLEMENTAL DEDUCTION i t �/ State Form 5473(R 19/1-23, HC70 a �.IT/ Frescnbed by the Department of Local Government F,nar:• 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) 448%4 E. 0 h{PnsC - .le certify that I(we)occupied as my(our)principal place of residence or am(are)buying the followm described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the datethi pplication is signed. ya�lRkt (date of signature) I(Wel ini r. ❑Am(are)buying under recorded contract 0 Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation I0 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 Owner's Name Recorder's Office Where Contract is Recorded Record Number Page PROPERTY DESCRIPTION County � � Township 02 � Taxing District(icitry�Ftown.township) i'50 lNA\`Yw'n-1 Pm,1e( Parcel Number Legal Description ;s the perty in estion DC.—U-o- �� -co I,b I X_ Oa\ 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 immediately surrounds that structure is used to produce income describe the use and portion of the property utilized to produce income PROPERTY OWNED ELSEWHERE BY CLAIMANT State.County.and Township Is Claimant Vacatr g a H mestea ❑yes No I hereby certify the above statements are true.correct,and complete -" '.-- Address of Contact jnum.er and street.city -tat- and ZiP code) _ss of located Homestead if any(number and street city.state.and ZIP code) ItiG• 5 Y„ ce t/ y1 1, ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE 1 NON-RESIDENTIAL VALUE Land Not Exceeding One(1)Acre Immediately (1) Surrounding Residential Improvement Other Land (2) • T T T T Total Land(line 1 plus line 2) (3) F I L ,rL"J1 ,■�,/), • Residential Improvements or Dwelling (4) Annually Assessed Mobile I Manufactured Home Garage (5) — JAN 4 2 2024 Other Improvements (6) IV V Total Improvements(Line 4 through Line 6) (7) Afirtt[(,C a PYr4 Total Value(Line3p/us Line 7) (6) _ ' GIBSON COUNTY AUDITOR Signatu-e of Assessor 'Date Signed(date month.year I hereby certify the above is true,correct,and complete. Venfymg Action-Signature of Auditor mate Signed(date month.year! STANDARD DEDUCTION ALLOWANCE 20 Pay 20 Lesser of 60%of the assessed value of the homestead or 648 000 Notwithstanding any other provision,the sum of the deductions provided in 1C 6-1 1-12 ro g a mobile Home that is not assessed as real property or to a manufactured home that is not assessed as real property may rot exceed one-half(1/2)of the assessed value of the mobile home or manufactured home Signature of Auditore- �� _ / Date Signed 1(month.day year) 11.2 if DISTRIBUTION: Original-County Auditor File-Stamped Copy-Taxpayer Page 1 of 2