Homestead_Buente_ ,' CLAIM FOR HOMESTEAD PROPERTY TAX
t CREDIT/STANDARD DEDUCTION
� State Form 5473 (R6I4A3)
' Prascnbed by ihe Departrnem ol Local Govemment Financa
� INS7RUCTIONS: See �everse side hr (ling instnictions.
-- - — -- ----�� YEAR
FORM �
HC10
� 1 �
�
I(We) � 1 certify that on the ist day of.March, 20
I(We) occupied as our prindpal place of residenc e following described real property (or which a Homestea'd�Bco erty^�'g',Tp��� it is hereby daimed:
� I(We) ovmed ❑ Are buying under co treci O�� V.
GIBSON COUNTY AUDITOR
Have a benefiaal interest in the entity Nat is liable for the property lexes on Ne property and that owns Ne property or is buying under a conVact.
ir � o�, �vea F� sm,ae rnm�rs �e
Recorders a(fica vmere convaa is recordad
��-oo ��-a� I `°�i'�"��J SW I �-
If any portian of Ne residantial shvcture or the land rwt exteedinp ona (1) ape that imm�
of Ne proparty utll¢ed W ptvduce Income.
�2' •/�i'- /� - �ao.-6ao.�r9- ��s
� �.� � --
i>_�,'Y` ''� .,�-. ya�-��`i'�.'2�5`� °;"}.;�kPROP,ERTY,OWNED`�BY_�CL/
Caunty To.vnship
I heraby certify the above statemenLS are We, correct and complete. �
ciry, ataie, Z/P cade)
TmMg dis ' ( , town,
�-� 0 j�wuvem
iateN wnwnds Net sW c
County
Signatute
RecoM number �PaBe
el property U Mobile Home Q.C. 67.7-n
is usad to produce iriwma, dascribe Ma use and portion
S .�s j �+v3 `3'.?i.'�.� °`C.s£ ,+cs.t{ V�"� .T "CAS-a�-v`''�' ..�}^ y L . . . . . . .
��m��� ASSESSOR USE�ONLY ,��':� �' ;;y�GTyq�UE �+ AT 1 0%OF T7Y�- K�H�VALUE� "'��.,� ON RESIDENTWL ��i:�
w at$ > ,�.�i-_:=s�_�F-"�� .� _ . , . � . .. _ .. .�.:VALUE t.
_ . .�[ y- a. _..r
Land not exceeding 1(one) acre�immediatety �,•�,4. t�.�'_Vs ��•� -_;:
surtounding residential improvemants. � '� �a ��`-" ��'.
( ) . ;�--.. � }:5.���^`�::F-..,.-
Other land _ Y "~
..fl•. k:
(2� _ -.•�.n:_
, � > � C't.,`�..
T�ial lami (line f plus line 2) �g�
�; � }Y+� �x � �i'y:
Residential improvemenLS or MnuaOy �����9 �4� '� �� v:�,ii� sa ��` `���
Assessed Mobile / Manufactured Home �: ,�x---�-ti �x� �
s
� �,
Garage (5) �;�t"�-�..�<�.��� �..:._���t.=:�
c."w:.
Ojqei improvements (8) j + - �?'
7ctal improvements (line 4 through liire 6) �7� _
Taal value (line 3 phs line � (g�
1 hareby certify the above is W e, correa, and � Signadre of Assessor Date signed
complete. � .
Verllying ealon • Slgnature otAUditw Data signed
20_Pay20_
Lesser of 1/2 Hwnestead
Valuatlon or $35,000
S