Homestead_Bean CLAIM FOR HOMESTEAD PROPERTY TAX
1, STANDARD I SUPPLEMENTAL DEDUCTION He FORM �/YE�A�R
.'y State Form 5473(R19 11-23) `02
`s' 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
♦ r`r
I(We) ►O A 1'1 II VNA - !' certify that I(we)occupied as my(our)principal place of
residence or am(are)buying e following desc bed eal property under!contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
a�tteethis application is igned, ' jLJAm
(date of signature),I(We):
wn. 70 (are)buying under recorded contract.
(are)entitledto ccupy astenant-stockholder of a cooperative housing corporation.
❑Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust.
❑Am(are)the shareholder,partner,or member of the entity that owns the property.
If Buying on Contract,Fee Simple Owner's Name
Recorder's Office Where Contract is Recorded Record Number Page '
PROPERTY DESCRIPTION
County ('/''�\ Township !fN]^ Taxing District(cifyilw,, ship) �u3
Parcel Number J tV1./ \t Legal Description th 'rropperty in question:
Real 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 immediately sun n that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
(37,0
2 \-24 - 3oo-
000 .mil ) -
..
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is Claimant Vacati .a • estead
Yes �'jo
natu of CI' ant r
I hereby certify the above statements are true,correct,and complete. t''';i. ❑
Address of Cont. t(number and street,city, tate,and ZIP code ish Address of Vaca d Homestea if a ( mbar a./.I,city,state,a • P code)
IP
ASSESSOR USE ONLY I ASSESSED VALUE 1 HOMESTEAD VALUE 1 NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement
Other Land (2)
i
Total Land(line 1 plus line 2) (3) Fit,
Residential Improvements or Dwelling (4)
Annually Assessed Mobile/
Manufactured Home Garage (5)
SEP202.i24
Other Improvements (6) ,/may
Total Improvements(Line 4 through Line 6) (7) - /7`7llc a
Total Value(Line3p/us Line 7) (8) GIBSON COUNTY A DITOR
Signature of Assessor Date Signed(date,month.year)
I 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 the homestead or$48,000.
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home that $ - -
is not assessed as real property or to a manufactured home that is not assessed as real property may not
exceed one-half(1/2)of the assessed value of the mobile home or manufacture t
Signature of Auditor ry\usal j,, -/� Date Signed( `�,h ,. a er {.j
DISTRIBUTION: Original-County Auditor,File-Stamped Copy-Taxpayer
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