Homestead_Norris III °a CLAIM FOR HOMESTEAD PROPERTY TAX
YEAR
t STANDARD/ SUPPLEMENTAL DEDUCTION FORM i
HC10 I
F-escnted by the Department or L-_a C:er^c•ert=••-a^c•
L^JSTRiCTIONS See reverse side for filing instruct!ons
NOTE Telephone.Social Secunty.driver's license state identification and federa,ioen56cabon numbers are confidential under IC 6-1 1-12-37.
''`` CERTIFICATION STATEMENT
I Me. �{ oc or r_r�_� _ cert fy that I I.se.occup•ed as my bur:principal place of
• res.derce or a^(are:buying t-ie foLL•::n-, --^/_ _a _ .. _r a Ho"-es:eal Property Tax Standaro Ced,.ct cn S hereby c'a Ted , e
date the app eat'cr a sped 7/A/4
G .- ❑qr_ arts �..y..,g....,_,, _<_.:_ .�..
Ar lore,ert.ted to occupy as a'era-'-st_s-: of a aoce.-a:.e c_s-g
❑Ha.e a be'efc:a,triter est tr tre --s._ . _ _ occupy t- --` _ _ - 3.- ea 3e _s.
4-- -< t^e shareholder,partrer or membe'of f.^e enb^y tt a; _ e
i
S Buy'rg or Contact Fee Simple Owlets Name
Recc'cer s O`tce hrere Certract's Recorded -_- ----- e -o Nur•ter aag= ,
PROPERTY DESCRIPTION
G I b S oh Tcv. - ' ?0.-I-o (0 w45_4/t
ma c.•W'..-:: - ' � Leja Jescspt
—G)— '//�y 004/4
-�� / „✓ f ❑Arn.:al y ifs essed•;::c -�r-.e --.
i'any porton of the res•dertla'slructc.e or theta^d rot eceed ag ore 1 a.,e a_,s. _• .,. a s.__.re s sed to a'cSaCe,come tlescrbe he use a^d port or
o'the prope.'.y.iC zed to prodcce•.navme
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State County and Township -estead'i
8-r
cre: G
hereby certify the above statements are tr. a.e caret.! and CO,' /
� .n-per and street oy Vile
1COC 'C v'sce . Z (474 769 5 95o w 0' 'L- v► l ie
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE I NON-RESIDENTIAL VALUE
Land Not eside One Acre Immediately I(1)
Surrounding
ingrig Residential Improvement
Other Land t2'
Total Land(line 1 plus line 2) - 3,
Residential Improvements or J Dwelling j;4; APR 0 5 2024
Annually Assessed Mobile I ry
Manufactured Home I Garage t5
Other Improvements (6i 4, WC-ht[GZ a filr.. K /
Total Improvements(Line 4 through Line 6) r7) GIBSON COUNTY AUDITOR
Total Value(Line 3 plus Line 7) '(81
S gra'�-e c esessc• --- ---- lace S g (dale _r_ ---
I hereby certify the above is true,correct,and complete.
:de S gned dale T
STANDARD DEDUCTION ALLOWANCE
.. - . estead S4_ -
,r..; stana,ng any crier cryr,s cn me s..m c!: _.._., _._rs pro... =5- r_ sc' s
s not assessed as'e-tl property or to a Ta^afactureS asTe'"a; s nor assessed as'e m a : ce^y 5, --
•
e.Ceeo one-bail:'.S :f'he assessed va•ve of he"cc'e^crme 7r manufaotv.r?C^C^?
_ _L% K - LtIs/may
DISTRIBUTION 2r;-ray- _ _-ce_S --axcaye'
gage 1 of 2