Homestead_Hochstetter ...•;:.....1, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
61,41,V I STANDARD/SUPPLEMENTAL DEDUCTION FORM
r2^'
•...;-,,,iiiii.., # State Form 5473(R19/1-23) HC10 U
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for tiling 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) r'innk ' • , • ev' certify that I(we)occupied as my(our)principal place of
residence or am(are)hi ,g the following described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
N a his application is signed, (date of signature).I
Own. (VVek
0 Am(are)buying under recorded contract.
El (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
El Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust.
0 Are(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 D3 Taxing District(city,town,towr0
CA,t .G
Parcel Number Legal Description I I a property in question: I
Real Property El 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 sum n s that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
\\..\,--.\ --3 ou„---00 0 .
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is Claimant Vacating a Homestead?
Dyes El No
X L ignature of Claimant
I hereby certify the above statements are true,correct,and complete. 1. Avv.)4414
Address of Contact(--•bar, Cl street,city,state,ond ZIP c.de) I ddress of Vacated Homest ,if any(number and street,city,state and ZIP code)
ci .,..,0 1,
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement
. .-....
Other Land (2)
Total Land(line 1 plus line 2) (3)
Residential Improvements or Dwelling (4)
Annually Assessed Mobile/
Manufactured Home Garage (5)
Other Improvements (6) ..,;7•:,,,;,':.:'.2:,.'„1, .,,...,"1.' ::
siAll'2 5 2025. .
Total Improvements(Line 4 through Line 6) (7)
Total Value(Line 3 plus Line 7) (8)
Signature of Assessor a ..tite_atidi,„ dy re Signed(date,month,year)
I hereby certify the above is true,correct,and complete.
Verifying Action—Signature of Auditor GIBBON COUNTY AUDITOI
ate 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-hail(1/2)of the assessed value of the 'Acme or manufactured home.
Signature of AuditorN (Kç 2
D . Date Signetil7y;V .......c
\....,s G)
DISTRIBUTION:Original—County Auditor,File-Stamped y—Taxpayer u
Page 1 of 2