Homestead_Breivogel, CLAIM FOR HOMESTEAD PROPERTY iAX; , ,,
CREDIT/STANDARD DEDUCTION
�� J�, St:��ePwm�73�H6/4-03:. ' ,.. . � .
Presui6aC by:�e DepaNnen� of Local Govemm:N Finance '' � �' � '
INSTRUC7lONS: See revwse side lnr /ifiiig ins6m:linus' � � �" �� ` ' -
?_ _s. �,.. _ .:i1' - . a3 ,::�_ � fi,�-+;�.'_�.°,i . _; s '°_.- `-.r.rconnrennu crn�uei
��
FORM
HC10
YEAR
�(We) �/Z� '�tify�hy o�i�t st day of March, 20_
I(We) occupied as our princip place o( residence lhe following described real prop y(or which a Homestead Property T�c Credi� is hereby daimed:
�� I(We) owned ❑!ve buying under conlract '�//y'���� �
'Have a beneficial interest in the entity that is liable for the property taxes on the property and Nat owns the (�Iope �g under a conVact.
IBSON COUNTY��
t«:�_-a.. a - �z �. � . a� � �1� t �ti-,, r, �.�,?-=CbNTRACT'RECORDED ��1,; , . .., ".-
-CZi.w�.'�i �.kcc,..':tif` ,. . "'�'�.� `� tt"`�i, ; - ' -
q.•
If buying om m�tract. Fee Simple owners namey -�
RecorEefs otfice where contraa is recorded � Record number Page
County
Toxnship
ESCRIP.TION; :�::"^�_ �'�v",°'..
Tmcing tlis�rict (city, fown, lownship)
�m
r rc n r /'� /�}� e I E n Is the property in question:
�Oa��.,J �W � �5�,� �� ❑ Real property ❑ Mobila Homo (I.C. 61.f-7)
If zny poaion o/ ��e resitlenUal sWCtura w the WnA not exceeding one (t) aae that imrtieaiately surrounds that swcture is used fn produce incorne, describe Ihe use antl portion
of !ha propeAy ulilizetl W Draduce inwme. . �
a . �-
County
�.�...�_...�
Tavnship
I hereby certify the above statements are We, cwtect and comptete.
(number and i(raef, uty, stale, ZlPtode)
Coun�y
Twvnship
��z�''.- �c ,�'-.i"-•;' �`� �'��` �''-` � �: �'� �J` 3' F` t'�7RUETAX�' ? �ASSESSED V/1LUE HOMESTEAD��' ��' � -NON,RESIDENTIALa' � ;�
� 1; sitt. � ,j ASSESSOR USE ONLY�..,� sa^ck �`;,;�: .�wVAI:UE .... � . _AT 100%:OF`TiV� �t_,�:sVALUE�� �.�Ei.�? `i�VALUE �.J„�{`��t'
°:.t�!'S.'i..f'..r"a..".'.i,.,'�u..._..'%-�L> .cx.,..:2'�s.; _ .,,t�„_._ n
F a St �+' a * N�
Land not exceeding 1 (one) acie immediately � � . E{ �, �`fY,(=�'� � = '�.x'a�'. :
surrounding rasidential improvements. (� � .��a.��"�,,-�.ae}�.�c-y'�F�`, � �;;>'y'�k�, . �
ONer land `�'�''`� �Y�'
(Z) �',�,t,�;�f,�,.a�#j '�.
`,._...5� .?�.e:�;
Total land (line 1 plus Irne 2) (g�
3, c.��.i 1ar�"sxi#`�,.�. ��3
Dwelling (4) " � a .'r5,� , r - :�<<
Residential improvements orMnuatly � 5 '' °�' �' ��� '�"'�''K �
9 5 � �`�� 'iis+: "b"�4o .
Assessed Mobile! Manufactured Home Gara e �i.-s'�s �'ir. ` s,�x•aa �r,.
( ) : t _�_.'•� x�� y s
..ri.. _
i �`�+3 .,h�•
Other improvements (6) , .� � �'
:,''-� .ar� sr„
Taal improvements (line 4 through line 6) (�)
Tdal value (line 3 plus line n (8)
I hereby ceAify the above is W e, correcl, and Signature oi nssessar Da�e signed
complete.
Verifying aclion - Signature o(lwditor Dale signetl