HomeMy WebLinkAboutHomestead_Halbig� Y CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Slate Fortn 5473 (R6 / 1-03)
Prescn6ed by the Department d �ocal Govemment Finance
INSTRUCTIONS: See revcrsc side (or liling ins(mclions.
FORM YEAR
HC10
� � � � �
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I(VJe) � certi(y at on the 1st day� bMarch, 20 _
I(We) occupied as our ncipal piace of residence Ihe following describe re I property for which a Homestead roperty 7�c-G�� t Ls� ereby dai
❑ I(We) owned ❑!ve buying under wniract GIBSON COU�i Y AUDITOR �
' Have a benefidal interest in Ihe enGry that is liable for the property taxes on the properry and that owns the property or is buying under a conVaU.
I( buying on conUad, Fee Simple ownefs name
Remtdefs oifice where mnVaa is recorCed
County
Tavnship
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li/V /'O�V� / ✓�I "1'a�scl.�/`� W �J'3�1 I Ilsihe7r°PeiJQ
I( any poNon of Na rasitlential sW cWra or the land not ecceeding one (1) aae ihat immediatety wrtounds tha��
at the properry ulilize0 tn produce i�ome.
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Record number � Page
al DropeM ❑ Mabile Homo (I.C. 67.1-7)
is usea to protluce income. describe the use and porUon
�„r.... v�. li^� r � 1. .t.c3 {��. sr ws•.. . ri's!'c:�se?'1'�,^a
�'��. ��`: x`ziev`�l'�-�c-'�rFS�.��"�`STAN�ARU:DEDUCTION'ALLOWAMCE..,x.���3'°a:?t;_�?i'��� _'..�`:�t�.'.�s.u,Er:*�,�<
20_Pay20_
Lesser of 1l2 Homestead �
vauauaiorf35.000 �
SignaWraofAUdit« ' Dates'�gned