HomeMy WebLinkAboutHomestead_StolzCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
` ` Slate Form 5473 (R8 / 7-07)
Prescnbed by ihe Depariment oi Laral Govemmenl Firiance
INS7RUCTIONS: See raoarse side /or filing ins6ucfions.
FORM YEAR
HC10
� �
��e� certity that on the 1st day of March, 2b_
�) ocwpied as our prindpa� place of residence the folbwing d ed real property fw which a Homestead Property T�6'gdi�i�'� daimed:
�(We) owned ❑ Are buying under contract GIBSON COUNTY AUDITOR
Have a benefiaal interest in the entity that is liable for the property faxes on the property and that owns the property or is buying under a contract.
�1 buyin8 an canirecl. Fee Simpla wmers rmme
RecorCers o15ce where contraq is recorded
coimb ramship
Pa� number
Legaldescnption
Is
town.
Record number � Page
� � �al propeM1y ❑ Mobila Fbme (IC 6-7.7-n
If any portion oi�he residarrtial aVUCture w Ihe Wnd nd enceeding one (1) acre thal immedately wrrounds that 9nuture is used W pmduce inmma, describe Ure use and portbn
of ihe properry ulifized b produce inoome.
°� lo- �8-i3-�'o �i-a�. �3Ga -aa �
.- .
. . .. . .
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Land not exceedirg 1(one) aae immediately �� ;, ,� .i..;�. � -_
surroundingresidentialimprovements. (�� - ' �E;., .� ,.- " _ .
Other WM - ,-'t;.: �., -
(2) ' �= ,',.,-., ,..: : '.
T�al WrM (line 1 plus line 2) �g)
Residential improvemenLS orMnually �ellirg (q) - , _ � �
Assessed Mobile / Manutadured Home � . . �
Garage (5) . �- .
Other improvements (6) - - '
Tdal improvements (Irne 4 through Gne 6) ���
Tcfal value (line 3 pl(s Grre n �g�
I hereby teftify �he above is We, tortett, aMl S"r,nawre of Assessor Date signed (mmN, day, yea�
camplete.
Vailying aclion - Sig�Wre MAUtlitw Date signed (monN, Oay, yea�
N � pay ��—i
Lesser of 12
Homestead Vaivation
or
45.000 for 2007 pay 2008 42.000 for 207 0 pay 2011
44.000 tor 2008 pay 2009 41.000 for 20N pay 2012 �
43,000 (or 2009 pay 2070 40,000 payable afler 2012
Signature otA" ta _ f� 1% � Date signed (manm� day, yea�