HomeMy WebLinkAboutHomestead_Moneye���� ; CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR �
'��°� � CREDIT/STANDARD DEDUCTION Hcio
` � Sute Form 5473 (RS I 10-01)
���� Prescribed by the Depariment of Local Govemment Finance
INSTRUCTIONS: See ieverse side for /iling inswctions.
�.;�`, 7 -"� ,y-; '' � - - � - CERTIFICATION STATEMENT � � � -
I(We) � ce dy tha on ie 1s�o arch. 20_
I(We) occupied as our prin pa p ace of r sidence e f Ilovring described real property for which a Homestead Pr�� Tmc 6red'A is}iereby daimed:
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❑ I(We) owned e buying under contr
. Have a bene5cial interest in the entity that is liable for ihe property tazes on lhe property and ihat own�e property o�s b�ng undeP a c�ptract.
c _ � '1�s�-tiF}i,.� t �'-�'�. i s �
If huying on conUaG.�Fee Simple ownets name
RetorEefs otfice whera wntract is remrded
Toxnship
�` GIBSON COUNTY AUDITOR I
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Remrd number Page
ESCRIP.TION : .-'� � ,?�.- •�. a- ...� •*, 4; _ _ ,
T�cing Dis ."ct �ry, rown, fownship)
X�u,e� a ���;�
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P rcel num�er ,/� � eg I es�j\iplio �I Is the O�operty i queslion:
�n��ML� � I��V � � � —/� . �11 �Real pro0er�y ❑ Mobilo Homo (1.C. 41.1-7)
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If any portion ot the residen6al sWCWre w the Wnd not exceeding one (1 � arre that immediately surtounds tha� s cture is used �o produce income. describe Ihe use an0 poNOn
ot the properry utilizetl to produce income.
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e=�5 � ' ^w - `" � ,�PROPERTYOWNEDBYCLAIMANT
County Tavnship Counry•
I hereby certify ihe above statements are We, wvect and complete. Sf na�
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�ddress (num6ei and sbeef, ciry, stafe, ZIP cade)
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i ,•, 's�_ � •.
; y���"� ASSESSOR USE ONLY -' �� r,TRUE-TAX ��ASSESSED VALUE HOMES7EAD= ��; �� NON�R/E LIUENTIAL��L t�
M . ��'�°��,�.��, ..y_' � " i7� � VALUE:. � AT100%OF.'.7"fV �� VALUEL
. s;:r _ . _ _. _ _ -. -
Land not exceeding 1(one) acre immediately - s' ' '�� ° '-
surroundingresidentialimprovementa ��) r �` �-� . �`? "' (.�-�
Otherland (2) „ .µ� �:�
� i�' t =x
x _,Y.....,r-. .
Tolal land (line 7 plus line 2) (3�
.. r_�} __y��.�-�
Dwelling (4) = t 5�`„ E� -*� �,7 `rc �:
Rasidential improvemenls ;' �F , a ' ��°'4.'
Garage 5 4�� 't?�u;�;�'�""���3'r`o��?'
( ) e. t3 '�;�`+`,. * ��x':»�at
�f.:, � :^.�'�
Olherimprovements (6) -� ;=Mi"`�;
Tolal improvements (line 4 through line 6) (��
TUaI value (line 3 pha line n (B)
I hereby certify Ihe above is We, corred, and Signature otasseswr Date sgned
complete.
Vrrilying action - Signawre of Audimr Date signetl
20_Pay20_
Lesser ot 7/2 Homestead
Valuafion or 56,000
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Date siyqeq.� _ � �
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