Homestead_Overton (5) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
'it' STANDARD/SUPPLEMENTAL DEDUCTION FORM
s HC10
54.3,R _, .23 —_—
F'escibed oy the Cepa^me^t o'L-_a Sc.er-te r°,a_:.
INSTRUCTIONS See reverse side for filing instruct ons
NOTE Telephone.Social Security,driver's license state rdentifcatron and federal ioenhficahon numbers are confidential under IC 6-1 1-12-37.
CERTIFICATION STATEMENT
.roe �veckc 1--- cart`y trot I lee'occup•ed as my'our prmcipa pace of
6I � i-►sr --
, s e t.ri oes ceo'__ _ ziet cc.i a cr a HOTestead Property Tan Standard Ded,cncn s hereby c'a-ed on the i
a!e! _ _s• _ s sgned .: / &,�y _ate of s,gnatur_r I We
E]AT!a'e ert:Ged to occupy as a tenant-star-c yet o'a c_c_ a:.a .._s•_ .,..r.,' i
'.e a oerefc:a,.nterest in the trust Or tre ._ce-: -___:_ _ :_ . -._ _:`a q,a.beo Oe•so^.a''es'denLe:'Ss:
A.T.;are;the shareholder,pan-er or membe- : e , d. - -orzoe
CLAIMANT'S INFORMATION
�Sxia SecuatyNumoercf Clamant s Spouse(last five dry ts. Criers erne I/en5fc` _.. •.. as- ^,State—__ -
I '
CONTRACT RECORDED
f Buy'.rg or Contract Fee Simple Owner s Na're
Reco7ders Off ce h`e•e CcrtreC-s Recorded er-rz
'..-c -.3
PROPERTY DESCRIPTION
Townsro
is A
.(1 I •200- W I. ✓47 -0.2 1 '/ -e^•i ❑Ar',.a y assessed Y,:ose!-a-.e,C
.'a-y c c d ra s. cze o•..e _ _._ _ _; r A.._. ..•. e:3-, _ -3.st ectsre s sad tc rdduce^come desP be the use and pxt= FILED
o!the proc_dy ut z_d.c predu_e rnme
MAR 2 6 2024
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State County and Township _ , - -�omestead'
-- —— — GIBSON COUNTY AUDITOR
I hereby certify the above s!alemerts are true correct and comp.e'-
/4(1412_ -
• .I:&• I((s `u sL, �e z N L.174G5
ASSESSOR USE ONLY I ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately a011Q�,d,�jN(100 NOS81J
Surrounding Residential Improvement
-- — 44
Sri p7%fl t/
Other Land - -- -- - - -- - - --- -- -- - --._- - -- -- -- i'
Total Land(line 1 plus line 2)
Residential Improvements or Dwelling 4 tiZOZ 9 Z a V I1
Annually Assessed Mobile I ---
Manufactured Home Garage
Other Improvements — — — C — T J
Total Improvements(Line 4 through Line 6) l 1 l��■L
Total Value(Line 3 plus Line 7) (8
S.snare c'ussessc- L1,3 Sg^ed(date
1 hereby certify the above is true,correct.and complete.
.er fyrg Action-S g^azure of Aud to :are S.gred date rrcro-
STANDARD DEDUCTION ALLOWANCE
2' _ Pa,2" Lesser of 5S=':of the assessed/3--e of!roe nun-estead]'141;DC
NOt.:rinstenoi'rg 3.^.y otter crd'r s.cn 'he s,^t cl:._._ .. _..ons J ^-r 1-42 -- cc - n -3. S
s not assessed as real proper,/or to a Tanufact,red`o•^e teat s-et assessed as'es--oC?"j
e'ceed ore-hail 1,2)of the assessed va-se of the rncr'e ncr e. manufactured name
Signature of Aadtor Cs-i _-. - ;ear,
3/ G/.2y
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DISTRIBUTION' 2..r gfral-;aunty A_Crtc• Fur.S'ae'ced-=cy--azzaye•
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