Homestead_Cargal jam, 1 CLAIM FOR HOMESTEAD PROPERTY TAX FORM i YEAR
I''‘ STANDARD/SUPPLEMENTAL DEDUCTION
Sate corm 5473(R19/1-23) HC10
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions
NOTE Telephone.Social Secunty,dnver's license state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
((we) 50 4,,e0\. J ( /1O` 3-1 certify that I(we)occupied as my(our)principal place of
residence or am(are)buying the following d ibed real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date this application is sgned 491r24/ati (date of signature) I(We)
GKwn ❑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
CONTRACT RECORDED
If Buying on Contract.Fee Simple Owner's Name
Recorder's Office Where Contract is Recorded Record Number I Page
•
PROPERTY DESCRIPTION
I County ti Township "axing District(city town.township)
G'\USb 11 p,- conlin
Parcel�l Number '1 y� Legal Description 's the property in questions
l a4^b if Ll_3b3_av a 1 5-O,0 eaI Property ❑Annually Assessed Noble Home(IC 6-11-7)
If any portion of the residential structure or the land not exceeding one(1)acre na:nn".ea.ate!y surrounds that structure is used to produce income describe the use and portion
of the property utl,zed to produce income
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State.County,and Township Is Claimant Vacating a Homesteads
❑Yes No
t
I hereby certify the above statements are true.correct.and complete
Address of Contact(number and street.city state and ZIP code) I Addres o acated Homestead if a (number and street oty.state and ZIP code)
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE ! NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement
Other Land (21
Total Land(line 1 plus line 2) (3) •
•
Residential Improvements or Dwelling (4)
Annually Assessed Mobile/
Manufactured Home Garage (5) '
r Improvements (6) •
Total Improvements(Line 4 through Line 6) (7) �: FILED
Total Value(Line 3 plus Line 7) (8) I
Signature of Assessor ;Date Signed(date month year! FEB 2 8 2024
I hereby certify the above Is true,correct.and complete.
Verfying Action-Signature of Auditor Date Signed(date month,ye r'
STANDARD DEDUCTION ALLOWANCE
.IBSON COUNTY AUDITOR
20 Pay 20 Lesser of 60%of the assessec._ __ _ _ .,:i or S48 OD:
Notmthstanding 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 rot
exceed one-half(1/2)of the assessed value of the mobile home or manufactured home
Signature of A of�I�l W flJ1 AAA/�i Date Signed( ndaj
_ i � I CP���
if
DISTRIBUTION: Original-County Auditor File-Stamped Copy-Taxpayer
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