Homestead_Davis (36) � ^
'� CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
'� .-' ''
•n, STANDARD/SUPPLEMENTAL DEDUCTION FORM
Cto 2024
ar State Form 5473(R19/1-23)
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)'Davis;Blake A - I certify that I(we)occupied as my(our)principal place of
residence or ern(are)buying the following described real property under contract for which a Homestead Properly Tax Standard Deduction Is hereby claimed on the
date this application Is signed,11/01/2024 (date of signature).I(We):
❑r Own. ❑Am(are)buying under recorded contract.
❑rim(are)entitled to occupy as a tenant-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.
CONTRACT RECORDED
If Buying on Contract,Fee Simple Owner's Name
• Recorder's Office Where Contract Is Recorded Record Number Page
PROPERTY DESCRIPTION
County Township Taxing District(city,town,township)
Gson 027 P Twsp
i'r r, Parcel Number Legal Description Is the property In question:
•
-I 0 Real Property ❑Amualy Assessed Noble Home(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that Immediately surrounds that structure Is used to produce Income,describe the use and portion
of the property utiroed to produce Income.
26-11-08-300-004.888-027
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,end Township Is Claimant Vacating a Homestead?
❑Yes ❑✓ No
ISigna e of Claima
I hereby certify the above statements are true,correct,and complete.
Address of Contact(number and sheet,city,state,and ZIP code) Address of Vacated Ho teed,If any(number and street city,state,end ZIP code)
5251 EW SR 64,Pton,IN 47670
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1) i .
Surrounding Residential Improvement
Other Land (2)
Total Land(line 1 plus line 2) (3) 1
Residential improvements or Dwelling (4) NOV 04 11J24
Annually Assessed Mobile/
Manufactured Home Garage (5)
Other Improvements (6) ' �i mired
Total Improvements(Line 4 through Line 6) • (i) i�IiSOON C (•(�. y'
GIBBON COUNTY 4tUDITOR
Total Value(Line 3 plus Line 7) (8)
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 properly may not
exceed one-half(1/2)of the assessed value of the mobile home or manufactured home.
Signature of Au 'm rD .--• Date Signed(month,day,year)
w \
DISTRIBUnON: Original—County Auditor,File-Stampe —Taxpayer
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