Homestead_White CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
1 STANDARD / SUPPLEMENTAL DEDUCTION FORM
\• State Form 5473(R21 i 7-25) HC10 �0�
r
''"`-'- 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) r 1 W certify that I(we)occupied as my(our)principal place of
residence or am buying the y.4 ' • .>. 41451 property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
•at• • is application is signed, (date of signature). I (We):
1:11 Own IN Arn(are)buying under recorded contract
II Am (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.
If Buying on Contract,Fee Simple Owner's Name
Recorders Office Where Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
County ^ Township Taxing District(city. town,township)
�Q . CO F.N764\U ,
Parcel Number 1 legal Description th property in question
eal 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 surroun tha tructure is used to produce income.describe the use and portion
of the property utilized to uce income
-- S --71C>-- \ O \ — COO . \ -1 -- O,
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State County Township Is Claimant Vacating a H.. stead?
ID Yes In No
Signature imant
I hereby certify the above statements are true, correct, and complete.
Address of Contact(number and ste cdy. state,and code) Address of ted Homes ad.if any(number and street, cay. state and ZIP code)
1 V2-- -� CAS) V\ — 1.)—'
ASSESSOR USE ONLY ASSESSEO VALUE HOMESTEAD VALUE NON RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement
Other Land (2) F IL Hill —
Total Land (Line 1 plus Line 2) (3)
Residential Improvements or Dwelling (4)
Annually Assessed Mobile! JAN 13 2026
Manufactured Home Garage (5)
Other Improvements (6)
Total Improvements (Line i through Line 6) •(7) /� ik���
Total Value (Line 3 plus Line 7) (8) GIBSON COUNTY cN�TY AUDITOR
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
For assessment dates after December 31, 2024: in 2025,
20___ Pay 20__ $48.000. in 2026,$40,000:in 2027.$30.000, in 2028. $20.000,
in 2029, $10,000: and beginning with the 2030 assessment date
and for each assessment date thereafter, $0
$
Notwithstanding any other provision. the sum of the deductions provided in IC 6-1 i-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 a assessed value of the mobile
home or manufactured home.
Signature of Auditor
Date Signed ( h. ar
'
DISTRIBUTION: Original -County Auditor File-Stamped Copy-Taxpayer
Page 1 of 3