Homestead_Blanchard (2) a' CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
10 \i STANDARD I SUPPLEMENTAL DEDUCTION FORM f� 1
5. State Form 5473(R1911-23)
HCtO a I ,
•/ 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) Aigli . •r• certify that I(we)occupied as my(our)principal place of
residence or am(are)buying the following dd--f n ed real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date this application is s,gned, "4, I ar if (date of signature) I(We)
Ian El Am(are)buying under recorded contract
0 Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation
' 0 Have a beneficial interest in the trust or the nght to occupy the property under the terms of a qualified personal residence trust
0 Am(are)the shareholder,partner,or member of the entity that owns the property
CONTRACT RECORDED
If Buying on Contract Fee Simple Owners Name
Recorder's Office Where Contract is Recorded I Record Number Page
PROPERTY DESCRIPTION
Court Township -axing District(city town,township)
C, 0 b SO►n az(e on
Parcel/ Number .�p Legal Description Is the property in question
ar
Older -2oa -QOD ,D lfS Q(ct I eat 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 rnnredatey 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 Vac,ing a-.mestead'
❑yes lig No
I hereby certify the above statements are true.correct.and complete Address of Contact(number and street.city state and ZiP code) -cdr ,eca.etl omestead if any(n er and street city.state code
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement
Other Land (2)
Total Land(line 1 plus line 2) (3) FILED
I i
Residential Improvements or Dwelling (4)
Annually Assessed Mobile l MAR 01 2024
Manufactured Home I Garage (5)
Other Improvements (6) •
Ac,�LtZGe (-2. /�71�/
Total Improvements(Line 4 through Line 6) (7) GIBSON COUNTY AUDITOR
Total Value(Line 3 plus Line 7) (8)
Signature of Assessor Date Signed(date month.year, ,
1 hereby certify the above is true.correct,and complete.
Verifying Action-Signature of Auditor Date Signed(date month.year)
STANDARD DEDUCTION ALLOWANCE
20 Pay 20 Lesser of 60%of the assessed value of tee- ^estead or s48 oc:
Notwithstanding any other provision.the sum of the deductions provided ins IC 6-1 1-12 to a mobile home that
is not assessed as real property or to a manufactured home that's 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 Audi r Date Sig I(mo>�day year) ____I
ipu Alia_
L_____. V 3
DISTRIBUTION, Original-County Auditor File-Stamped Copy-Taxpayer
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