Homestead_Schmitt (7)CLAIM FOR HOMESTEAD PROPERTY TAX
_ STANDARD/SUPPLEMENTALDEDUCTION
` State Form 5473 (R13 / 12-09)
� � Presaibed by tha Deparhnent of Loral Gwemment Finanre
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INS7RUCTIONS: See raverse sfde /or filirw insfnictions.
i_ ��� � i� �I
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��yye� ¢ � . � certify that I(+ve� ' as my (our) prindpal
place of residence or am (are) buying the following described real property fw which a Homestead PropeAy Tax Standard Ded aUon's hereby daimed
V
'ercontraCOnthedatethisappliptionisfiled, (dateo/filing),I(We): GIBSONCOUNTYAUDITOR
❑ Am (are) buyirg under recorded conirect
Am (are) entllled to occupy as a tenan4stockholder of a cooperaUVe housing corporation
❑ Have a benefidal interest in the Wst or the right to ocwpy the property under ihe tertns of e qualified personal residence Wst .
❑ Am (are) the shareholder, partner or member of ihe entity that owns the property.
•- • •
rtama d t (kga� �eme)
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sodal Seacib o aaimanufl(�v/rrve d�llon � oNer �ssuing sate
Name of ImanYs spouse (b9a1 name)
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Sotlal Sewriry
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I( buying an conGaa. Fea Simple awnets �ame
Remrdeh ofGce w�M.�e conbeG is remrded Retord numhei Page
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��H Township Taritg distrid (dry, futm'fownshiP)
Pa�cel number Legal desMption Is e propgty in puestidv
� poperty ❑ a,o�any essessea moboe nome (rc G,.,-n
It arry ponion of the residential sWCture w 1he land not ezceeding one (1) arle Uat Qruned"ately surtdm that sWdure a used m praduce ir�come, tlesaiba the use and portion
ol Ihe property utilized In produre Income.
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Caunty Tamship Counry Ta.msNp
I hereby certiry the above statements are we, cortect and complete. X✓ �'� � Z
Address (numDer and sbeel, dry, state, LP )
7�6a " �os s .� �3
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Land not exceeding 7(orre) acre Immedlately � r-�: "+- ���*-' Y�,� <� ���,
surtoundin residentlal Im rovement5. � � � � -F � ��� ` • �
�. s..z:':.��s� ;�;,: �+'"=e
Other land (2) i `,,.�:;;:�. `: ��r°'
Total land (line 1 plus lirre � (3)
'Sxt "3re•',"' ..'''i�F..aC"'a5�<`4''jrsR
Residentlal Improvemenfs or Mnuafly �IIIn9 (<) f�.,_ �' z ;' c� psU:£F ;-_
e�__°^ Mobtle / Manu(aeNred Home Gara e r�`'f '' ��< �„�tr'�v.�� ��'r•.F-
9 (5) S.W.. � : .,r-�p .
Otherimprovementa (6) x � �h�'"�: � �
Total improvemeMS (line / fhrough line � (7)
Toml velue Qine 3 p!'a Ilne n (8)
I hereby certify the a6ove Is We, correet, �9^ewre of Assessor Date signea (month, deY. Y'��
and complete.
Verifyvig action - SigraNre of Auditw Date sigrred (rtanth. daY. yeerJ
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20 _ pay 20 _ Lesser of 60% of the essessed value of ihe hanestead or $45,000
NohviMStandLg any ott�er provisbn, Ne sum o7 Ne deductions provided in IC G/.7-12 ro e rrobile Mme Naf is $
raf assesmJ es real poperry a to e menufaGUred home U�at is not essessed as real property maY rat erceed -
one-heH f2) W Ne essassed rahre W tM mo6i7e home ormenufaUUred Mme.
����y ofq�y� Date signetl (monfh. day, yea�