HomeMy WebLinkAboutHomestead_Block�, •.�' CLAIM FOR HOMESTEAD PROPERTY TAX
° CREDIT/STANDARD DEDUCTION
� 54ta Form 5473 (R6 / 4-03)
' Piescribed by Ne DepartrneM ol Local Govemment Finance
� INSTRUCTIONSi See ieverse side for filing instnations.
1 FORM YEAR
` q HC10
�`� �
� M'8) 1/ 1���an'�- i[J y�'-�`x certify that on the tst day of Merch, 20_
I(We) occupied es our prindpal place of residence the following described real property for which a Homestead�� ja���/.it is hereby daimed:
I(We) owned � buying under contrea d v
GIBSON COUNTY AUDITOR
Have a benefidal interest in the entity that is liable for the property taxes on Ne property and Nat owns the property or is buying under a conVaa.
Counry
VI/ / -
n e�y Port�o� Or t
of tha proparty ui
Tormship
Legal descripfion
Tadng
Is Na
:Jln /— �J I V lU oS ' :l %U /) I
+dentlal strudure w the IarM not exceeding ona (1 � acre Net immediatey wrtounds Nat
to produce income.
Q,!ue�s,tion:
�=yD�Perty ❑ MoWle Home (LQ G7J-7)
e is used to ptoduca incqna, desuiba Ne use and portion
� �-/�7'-lJ� - a 306 -QQO. G�7- Do3 � I
_"''��� ��``'�'R`'��'�'�"�T���'� �',�2t�` j�� �TRUE TAX�"'� ASSESSED V/LLUE '� HOMESTEAD� � r NONd2ESIDENTIAL"" �
'�� `. b�3 ASSESSOR USEaONLY z� ,.x�x , -�y�UE �'���' �AT 100°/.OF TTY ,.� -'=VALUE""� ?- "��� -'?���VALUE� -�..
�i�L_.:r.'�,�,.�'rt,ro�'�§rl1'�:.4i.'D� :�$.��'� � � .._,�...� ..,._. � S. - �ry,.� - . '? exi'�.r �4`�, ...,. �+ � :.:�
Land not exceedin 7 one acre immediat '' �'� :Y�'L- z ;:
9 ( ) eN � `;s�.�tt�'r ,��� , « r :
surrounding rasidantial improvements. � � T;;a..;�'F`,p.'�'�r._„ � �.;,SL'�y.:���
Other�and �p� � r ._-�;.,;'�"'?'
^.`r-.�_.'��'.
Tctal land (Ilne 1 plus Ilne 2) �3�
,i.2x� «ti"v.�n `,•m�'' 0';4�, �.
Dwelling (4) �� F �{'�,.{- ;`r
Residential improvements or Mnualiy �'?�»' �� ��;�z i : ' -s- 'x
Assessed Mo6ile / ManuFaUUred Hame ;4;s �"f,."�; r���,- a�."'�, 3�i
Garage �5) a.",���.t=,.<.^-'3 �;-; --- ,'�'"`-
c c:. _
O�be� improvements (6) ;:�:�`-:;'�` _:. �-�
Tctal Improvements (line 4 through lirre 6) (7) .
Tttal value (line 3 phs line n �g�
I hereby certify the abova is We, cortect end � signawre otnssessor � oa�n signed
complete.�
Verilying actlm - SignaNre oflviditor Date signad