Homestead_FeutzCLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
Stete Form 5473 (R614-03)
Presuibed by Ne Departmmrt d Local Govemmrrt Finana
INSTRUCTIONS: See ieverse side lor �ling insfi.ctions.
I(We) � certify that on �thye ,1,st day of March, 20_
I(We) occ ed as our principal place of residence e ollowing described real property for which a Homestead Property,Tar! �i{ .�5" �by daimed:
❑ I(VJe owned ❑ Are buying under contract _ GIBSON COUNTY qUDITOR
' Have a benefidal interesl in the entiry that is liable for the property taxes on ihe property and fhat owns the property or is buying under a canVac[.
I( 6uying om m�tracl, Fee Simple ownefs name
Remrders afice where wnVacl is remrded
Counry
Pa be�
�
I( any portion ol Ne resid
or the prope+ty utilized lo
Tavnship
sWCture w the
xe irKOme.
Tacing tlistrict (tiry, fown, fownship)
�^—��_Ilslhepropertyinquestion:
!�{ / ( ❑ Real OroM
RetArd number
❑ Mobila Hwno
Page
c�,. r-n
azceeding one (1) aae Na mediatey sunounds that sWCtura is usetl lo produce income, describe Ne use and portion
�O c �c.
_oas
-��'a��` t��"` `rs"r'�''�' '�T� € "` r -�i:�`'"TRUETAX�-*`�� ASSESSEDVALUE �aHOMESTEAD` � NO�N'-RESIDENTIAL h
�+'i,'�`..A�F.'TASSESSOR USE,ONLY✓ � c.,'�•,{� �.pVALUE"'}' ' AT 100°/a OF�TN `^'� '�' � VAI.UE '�/`3���
�t?�7_�.:c�;�, . L�_',:. . ..-���d�� ��___•. '�. .... : 7.,�.....� as'Ke�VALUEs � ���'�z`�:''�'�. ....,�.rY:.0 �_
....ea
Land not exceeding t(one) aae immediatery (' � ;t���N,�};�;�c �'�����„�1s�
surtounding residential improvements. �Y� iiw��� .r..,f'�'1� c
�--:.:,��^+�;-;��r::
Othe� tand -��-� �+�;�-� tk-
(Z) i?�?'",.��.�" :�.4s`�`�,�';�'�
�.�.,,x.-si `::+._� .�
7otal land (line 1 plus line 2) �3�
Dwelling (4) �����i��� • s��
�Residential improvements or Mnualry � {„ ��
Assessed Mobila / Manufactured Home Garege (5� s.�,�k� .'^�4��������
�- � �Y-_ _
a s�. -, �..�
Otherimprovements (6) �`�"`W���'"` "��
-�,_`�;���
Tdal improvements (line 4 fhrough line 6) (7)
Tctal value (line 3 plts line n (g�
I hereby certify ihe above is We, correG, and Signature of assessor Date signe0
comptete.
Verifyi�g action - SignaWre of fwditor Date signea