HomeMy WebLinkAboutHomestead_JohnsonCLAIM FOR HOMESTEAD PROPERTY TdX
CREDIT/STANDARD DEDUCTION
Sleta Fortn 5173 (R6l {-03)
Preacribetl by the Depei6ne�rt o! Lxil Govemment Finar�ce
INS7RUCT10NS: See rewrsa atd� px IBYp etr�ycy'pro,
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Q�� FORM
HC70
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I(VJe) �/L �`"�� certify that on the 1st day of March, 20_
I(VJe) occupied as our principal place of reside�ce the fo owing described real prop for which a Homestead Propertyj7a��c C.redi�s"hereby daimed:
❑ I e owned ❑ fve b J�� (J ��
(�'� ) uyingundercontract GIBSON COUNTY AUDITOR
, Have a benefidal interesl in ihe entity thal is liable for ihe property tazes on the property and that owns the property or is buying under a wntraU.
If buying on coniraq, Fee Simple owners name
Remrdefs ofice where mnUacl is remrded
7�S
Tomship
Legal
Tating dislrict (ciry, fown,
the
H any portion of the rasidentlal sW cWra w ihe land not exceedirb one (1) arje Nat immediatety surtounds Ihat
af Ne properry utilaed fn produce inmme.
� � c�G-�I 3a-/o�-�.��-�d�
Record number � Page
❑ �dobile Homo G.C. 6f.
is used to produce income. describa the use antl porton
��"'�4 �� ��r�'"`�� �` �'-'�r"`"TRUETAX��� ASSESSED�VALUE�HOMESTEAD��� NON,`-yRESfDEtiTIAL�-���
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���K ..ASSE�S4n�,�E�O�NLY. ;- K��'.�� ".'tY.�s .-�`�VALUE�z�� 'tAT�100%'O�TN� -�`r"�V/1LUE� .r-�"`-VALUE�.;�,$'�Y�
Land not exceeding 1(one) acre immediately �-�7"#��.`�" "`�-�i.�',��
suvounding residen6al improvements. �� � ��'�,.-�, ,�����",e�'..�'�`.
Y-. �'c .r-... w�+
Otherland z £��`���� �
( ) a .�s�-�z�
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Total iand (line 1 plus line 2) (3�
4��'��'� RS`� �=e�-�=�
Dwelling (4) �,,,��r�a�i������
Residential improvemenLa a Mnuatly �,
Assesaed AbbOe / ManufacNred Hane Garage (5� � �"� � � '� �"��
���'�� '�.;�• . ��'
Other improvements (6) '""'�.��'� ��
�. _. �� r�
Tdal improvements (line 4 through line 6) (��
Total value (line 3 plus line � (g)
I hereby certi(y the above is W e, corted, and SignaNre of Assessor Date signed
complete.
Veri(yfng aclion - Signature otlwditor Date signed
20 _ Pay 20 _
Lesserof 1/2 Homestead
VelUeUan
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