Homestead_Blaize CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
S.i STANDARD/ SUPPLEMENTAL DEDUCTION FORM• q/// --;
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✓es ced o,t e'C 3-.Te-''.'_- -' - a •
INSTRUCTIONS See reverse s de for fhng instruct ons
NOTE Telephone.Social Security driver's license state identification and federa,ioenhfication numbers are confidential under IC 6-1 1-12-37.
TT Q CERTIFICATION STATEMENT
I;We. .sft V 3ja►eze — — - ___s . :.^.Cipa'place of
ri res de ce or am are.baying the foto.v.ny des:-;Rd rea'.prof=_ , - t n-.s =r a Ho-rester: - . _ - - _ _ c a.—ed Jr the
date th s app'eauer a s gned Y/s/.?'/ -
,;v� ❑A— a•e ..y-,g u, _ _ --C
AT(are,entitled to occupy as a tens -stocitrcider of a c cope-at._-c_s 7.__a.
❑Ha.e a oereec'a:rterest m tie trust or the rignt to occupy ire c'ece^, _ r - - J..a --‘s-- = _s
❑A- are;the shareholder pa^.-c'
CLAIMANTS INFORMATION
'
CONTRACT RECORDED
'!Buyrg on Contract Fee 5,rnpie Cwne•s Name
Recorder s Ott ce A`e'e Oct-tract s Recorded_ hero •- i Say
PROPERTY DESCRIPTION
County Tcwns.ro • ,. .
;bson ( 6 - K—Ve R:JEr
'a•oe��r^fe• Lego!Descriptor,
VV-Uc-C4- 00 -oMa.Da—Otn
Asscsned''tide oP-e C°'_
i'any canon of tee res-de^t,a's:r„st-re or the 3-_"_t e._ee:rg ore 1,3_e .,. _ .= a st,C.re s..sed t:.._d„_e^.come describe the-se a^d poi cr
o!the proce-ty at zed to prod_ce rccme
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State County and Township •
�:/-..'
❑lea Lam..
I hereby certify the above statements a roe : -< and compiete
-- _ -- ---_ -- - — --- - ---- - - !Tessa.scatted-•=r'esteii 'am r'on aer and street tcty •e and Zi rode
(4) , Al v _ . aZ 4dn 76'YQ
ASSESSOR USE ONLY I ASSESSED VALUE HOMESTEAD VALUE I NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement _ I
Other Land i2, FILED
Total Land(line 1 plus line 2) i3r
Residential Improvements or Dwelling 1141
Annually Assessed Mobile I
Manufactured Home Garage 5; APR 0 5 2024
Other Improvements (6,
Total Improvements(Line 4 through Line 6) Aide'LCCil C&' i.f6.•n,)
Total Value(Line 3 plus Line 7) '(8) GIBSON COUNTY AUDITOR
S,gratr-e o!Asses.
I hereby certify the above is true,correct.and complete.
veefyerg Actbs^-S.g^ar+re of tuo•c. S o,-
•
STANDARD DEDUCTION ALLOWANCE
20__Pay 2C__ Lesser of 3 ':of the assessec.; .
Not:d m a cbc
nstanding an,otrer crovis,Cr 'ne su :re de5r. rs pro.ceC r 5- -'2 r= - o
is not assessed as reel;properr/or to a ma^ufactared"O.me t°a: s"Pt assessed ras'ea'
I eeceed one-had 1,2;of the assessed ease of the•no0,,e home manufactured^G^'e
Signature cf Aad'tor euedir444, y,/4/��
DISTRIBUTION- 2r,rai-Oat^ty A-dnc• =.e.StaT.ce__op,- a+wye•
Rage 1 of 2